Prostate cancer in detail


Prostate cancer affects the prostate gland, the gland that produces some of the fluid in semen and plays a role in urine control in men.

The prostate gland is located below the bladder and in front of the rectum.

In the United States (U.S.), it is the most common cancer in men, but it is also treatable if found in the early stages.

In 2017, the American Cancer Society predicts that there will be around 161,360 new diagnoses of prostate cancer, and that around 26,730 fatalities will occur because of it.

Regular testing is crucial as the cancer needs to be diagnosed before metastasis.

Fast facts on prostate cancer:

Here are some key points about the prostate cancer. More detail is in the main article.

  • The prostate gland is part of the male reproductive system.
  • Prostate cancer is the most common cancer in men.
  • It is treatable if diagnosed early, before it spreads.
  • If symptoms appear, they include problems with urination.
  • Regular screening Is the best way to detect it in good time.

Symptoms

There are usually no symptoms during the early stages of prostate cancer. However, if symptoms do appear, they usually involve one or more of the following:

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  • frequent urges to urinate, including at night
  • difficulty commencing and maintaining urination
  • blood in the urine
  • painful urination and, less commonly, ejaculation
  • difficulty achieving or maintaining an erection may be difficult

Advanced prostate cancer can involve the following symptoms:

  • bone pain, often in the spine, femur, pelvis, or ribs
  • bone fractures

If the cancer spreads to the spine and compresses the spinal cord, there may be:

  • leg weakness
  • urinary incontinence
  • fecal incontinence

Treatment

Treatment is different for early and advanced prostate cancers.

Early stage prostate cancer

If the cancer is small and localized, it is usually managed by one of the following treatments:

Watchful waiting or monitoring: PSA blood levels are regularly checked, but there is no immediate action. The risk of side-effects sometimes outweighs the need for immediate treatment for this slow-developing cancer.

Radical prostatectomy: The prostate is surgically removed. Traditional surgery requires a hospital stay of up to 10 days, with a recovery time of up to 3 months. Robotic keyhole surgery involves a shorter hospitalization and recovery period, but it can be more expensive. Patients should speak to their insurer about coverage.

Brachytherapy: Radioactive seeds are implanted into the prostate to deliver targeted radiation treatment.

Conformal radiation therapy: Radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ or region that requires treatment. This minimizes healthy tissue exposure to radiation.

Intensity modulated radiation therapy: Beams with variable intensity are used. This is an advanced form of conformal radiation therapy.

In the early stages, patients may receive radiation therapy combined with hormone therapy for 4 to 6 months.

Treatment recommendations depend on individual cases. The patient should discuss all available options with their urologist or oncologist.

Advanced prostate cancer

Advanced cancer is more aggressive and will have spread further throughout the body.

Chemotherapy may be recommended, as it can kill cancer cells around the body.

Androgen deprivation therapy (ADT), or androgen suppression therapy, is a hormone treatment that reduces the effect of androgen. Androgens are male hormones that can stimulate cancer growth. ADT can slow down and even stop cancer growth by reducing androgen levels.

The patient will likely need long-term hormone therapy.

Even if the hormone therapy stops working after a while, there may be other options. Participation in clinical trials is one option that a patient may wish to discuss with the doctor.

Radical prostatectomy is not currently an option for advanced cases, as it does not treat the cancer that has spread to other parts of the body.

Fertility

As the prostate is directly involved with sexual reproduction, removing it affects semen production and fertility.

Radiation therapy affects the prostate tissue and often reduces the ability to father children. The sperm can be damaged and the semen insufficient for transporting sperm.

Non-surgical options, too, can severely inhibit a man’s reproductive capacity.

Options for preserving these functions can include donating to a sperm bank before surgery, or having sperm extracted directly from the testicles for artificial insemination into an egg. However, the success of these options is never guaranteed.

Patients with prostate cancer can speak to a fertility doctor if they still intend to father children.

What causes prostate cancer?

The prostate is a walnut-sized exocrine gland. This means that its fluids and secretions are intended for use outside of the body.

The prostate produces the fluid that nourishes and transports sperm on their journey to fuse with a female ovum, or egg, and produce human life. The prostate contracts and forces these fluids out during orgasm.

The protein excreted by the prostate, prostate-specific antigen (PSA), helps semen retain its liquid state. An excess of this protein in the blood is one of the first signs of prostate cancer.

The urethra is tube through which sperm and urine exit the body. It also passes through the prostate.

As such, the prostate is also responsible for urine control. It can tighten and restrict the flow of urine through the urethra using thousands of tiny muscle fibers.

How does it start?

It usually starts in the glandular cells. This is known as adenocarcinoma. Tiny changes occur in the shape and size of the prostate gland cells, known as prostatic intraepithelial neoplasia (PIN). This tends to happen slowly and does not show symptoms until further into the progression.

Nearly 50 percent of all men over the age of 50 years have PIN. High-grade PIN is considered pre-cancerous, and it requires further investigation. Low-grade PIN is not a cause for concern.

Prostate cancer can be successfully treated if it is diagnosed before metastasis, but if it spreads, it is more dangerous. It most commonly spreads to the bones.

Stages

Staging takes into account the size and extent of the tumor and the scale of the metastasis (whether it has traveled to other organs and tissues).

At Stage 0, the tumor has neither spread from the prostate gland nor invaded deeply into it. At Stage 4, the cancer has spread to distant sites and organs.

Diagnosis

A doctor will carry out a physical examination and enquire about any ongoing medical history. If the patient has symptoms, or if a routine blood test shows abnormally high PSA levels, further examinations may be requested.

Tests may include:

  • a digital rectal examination (DRE), in which a doctor will manually check for any abnormalities of the prostate with their finger
  • a biomarker test checking the blood, urine, or body tissues of a person with cancer for chemicals unique to individuals with cancer

If these tests show abnormal results, further tests will include:

  • a PCA3 test examining the urine for the PCA3 gene only found in prostate cancer cells
  • a transrectal ultrasound scan providing imaging of the affected region using a probe that emits sounds
  • a biopsy, or the removal of 12 to 14 small pieces of tissue from several areas of the prostate for examination under a microscope

These will help confirm the stage of the cancer, whether it has spread, and what treatment is appropriate.

To track any spread, or metastasis, doctors may use a bone, CT scan, or MRI scan.

Outlook

If the disease is found before it spreads to other organs in a process known as metastasis, the 5-year survival rate is 99 percent. After fifteen years, this decreases to 96 percent. Once the cancer metastasizes, or spreads, the 5-year survival rate is 29 percent.

Regular screening can help detect prostate cancer while it is still treatable.

Risk factors

The exact cause of prostate cancer is unclear, but there are many possible risk factors.

Age

Prostate cancer is rare among men under the age of 45 years, but more common after the age of 50 years.

Geography

Prostate cancer occurs most frequently in North America, northwestern Europe, on the Caribbean islands, and in Australia. The reasons remain unclear.

Genetic factors

Certain genetic and ethnic groups have an increased risk of prostate cancer.

In the U.S., prostate cancer is at least 60 percent more common and 2 to 3 times more deadly among black men than non-Hispanic white men.

A man also has a much higher risk of developing cancer if his identical twin has it, and a man whose brother or father had prostate cancer has twice the risk of developing it compared to other men. Having a brother who has or has had prostate cancer is more of a genetic risk than having a father with the disease.

Diet

Studies have suggested that a diet high in red meat or high-fat dairy products may increase a person’s chances of developing prostate cancer, but the link is neither confirmed nor clear.

Medication

Some research has suggested that non-steroidal anti-inflammatory drug (NSAID) use may reduce the risk of prostate cancer. Others have linked NSAID use with a higher risk of death from the disease. This is a controversial area, and results have not been confirmed.

There has also been some investigation into whether statins might slow the progression of prostate cancer. One 2016 study concluded that results were “weak and inconsistent.”

Obesity

It is often believed that obesity is linked to the development of prostate cancer, but the American Cancer Society maintains that there is no clear link.

Some studies have found that obesity increases the risk of death in advanced cancers. Studies have also concluded that obesity decreases the risk that a cancer will be low-grade if it does occur.

Agent Orange

Exposure to Agent Orange, a chemical weapon used in the Vietnam war, may possibly be linked to the development of more aggressive types of cancer, but the extent of this has not been confirmed.

What to know about blood in urine (hematuria) in females


Hematuria refers to the presence of blood in the urine. Some causes are specific to, or more likely to affect, females.

Blood in the urine is often due to infections, kidney problems, or injuries.

In this article, we discuss the possible causes of blood in the urine in females. We also discuss when to visit a doctor, diagnosis, treatment options, and what blood in the urine can mean for children.

Causes

Hematuria can occur when part of the urinary tract, which includes the kidneys, bladder, and ureters, sustains damage or becomes irritated.

However, blood that appears in the urine does not always come from the urinary tract. In females, blood from the vagina, cervix, or uterus may appear in the urine, giving the false appearance of hematuria.

Types of hematuria include:

  • Gross hematuria, where a person can see blood in their urine. The urine can appear pink, red, or brown.
  • Microscopic hematuria, in which the urine contains trace amounts of blood that are invisible to the naked eye. Microscopic hematuria accounts for 13% to 20% of urology referrals.

Causes of blood in the urine in females can include:

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Urinary tract infections

Females have a higher risk of developing urinary tract infections (UTIs) due to the location of their urethras.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), at least 40–60% of women experience a UTI in their lifetime.

UTIs occur when bacteria from the bowels enter the urethra, the tube that carries urine out of the body. A UTI can travel up the urethra and infect the ureters, kidneys, or bladder.

A UTI can cause people to feel a frequent and urgent need to urinate.

Other symptoms of a UTI can include:

  • painful urination
  • cloudy or foul-smelling urine
  • blood in the urine
  • pressure or pain in the lower back, abdomen, or pelvic area

Stones

Excess minerals can form hard deposits or stones in the bladder and kidneys.

Stones may tear or scratch the lining of the urinary tract and its associated organs. Blood from these tears can mix with the urine, resulting in either gross or microscopic hematuria.

Stones in the urinary tract can cause the following symptoms, according to the NIDDK:

  • pink, red, or brown urine
  • frequent urination
  • incontinence, or involuntary urination
  • painful urination
  • cloudy or foul-smelling urine

The following factors may increase a person’s risk of developing stones, according to the Urology Care Foundation:

  • dehydration
  • consuming large quantities of salt
  • gastrointestinal conditions, such as Crohn’s disease or ulcerative colitis
  • thyroid problems
  • being overweight or having obesity

Endometriosis

Blood in the urine that accompanies severe lower back pain may indicate endometriosis, a common health condition that occurs in more than 11% of adolescent and adult females in the United States.

Endometriosis occurs when tissue similar to the endometrium — the lining of the uterus — grows in areas of the body outside of the uterus.

Although endometriosis can affect any part of the body, the Office on Women’s Health state that it commonly involves the following areas:

  • outer lining of the uterus
  • ovaries
  • fallopian tubes

Without treatment, endometriosis can affect fertility.

Cancer

Although it does so less commonly than infections and stones, cancer of the kidney or bladder can also cause hematuria.

The urine may contain blood one day and appear clear the next. A person should not wait for the blood to reappear before contacting a doctor.

Bladder cancer can cause a person to urinate more or less frequently. Kidney cancer does not typically affect a person’s urination habits, but it can cause lower back pain.

Diagnosis

Treating blood in the urine requires an accurate diagnosis of the underlying cause. A doctor may start the diagnosis process by reviewing a person’s medical and family history for any contributing risk factors.

They are likely to ask females when their last menstrual period occurred. The presence of menstrual blood in the urine can result in a false positive hematuria diagnosis.

Doctors use the following tools to diagnose blood in the urine:

Pelvic exam

During a pelvic exam, a doctor will assess the condition of the female reproductive organs, including the:

  • vulva
  • vagina
  • cervix
  • uterus
  • ovaries

Depending on the reason for the evaluation, the doctor may examine the bladder and rectum as well.

Urinalysis

A urinalysis tests for protein, blood cells, and waste products in the urine. It can identify a range of medical conditions that affect the urinary tract, such as kidney disease and UTIs.

Imaging tests

Imaging tests can detect stones, endometriosis growths, and cysts in the urinary tract and pelvis.

Imaging tests can include:

  • ultrasound tests
  • MRI scans
  • CT scans
  • cystoscopy

When to see a doctor

People should not wait to see a doctor if they notice blood in their urine. They should speak with a doctor even if the blood clears on its own.

Females should speak with their doctor if they see blood in their urine outside of their regular menstrual period, especially if it occurs alongside the following symptoms:

  • severe pain in the lower back, intestines, or pelvis
  • gastrointestinal problems, such as constipation, diarrhea, or nausea
  • painful urination
  • cloudy or abnormally colored urine
  • foul-smelling urine
  • fever
  • chills
  • fatigue

Blood in urine in children

UTIs, stones, injuries, and some inherited diseases, such as polycystic kidney disease, can cause hematuria in children. In general, hematuria will not cause further complications in children. It may resolve on its own without treatment.

However, parents or caregivers should still take the child to see a doctor.

In most cases, a doctor will use a physical exam and urinalysis results to diagnose the underlying cause of hematuria in a child.

The presence of blood and protein in the urine may indicate an issue relating to the kidneys. In this case, it may be best to take the child to see a nephrologist, a healthcare professional who specializes in treating kidney conditions.

Treatment

Treatments for hematuria will address the underlying cause.

UTIs

A doctor may prescribe a course of antibiotics to treat hematuria that is due to a bacterial UTI.

Stones

People who have kidney stones can expect an improvement in their symptoms after they pass the stone. Large stones may require either medication, a special procedure to break the stone into smaller pieces, or surgical removal to relieve the symptoms.

Cancers

If a doctor finds that a person has kidney or bladder cancer, they will usually refer the individual to an oncologist, a healthcare professional who specializes in treating people who have cancer.

Treatment options for kidney and bladder cancer include surgery, chemotherapy, and radiation. Treatment programs will vary from person to person, depending on the stage of cancer and whether it involves other organs.

Summary

A doctor can help diagnose the cause of blood in the urine. Some causes, such as endometriosis, are specific to females, and females are more likely than males to experience UTIs.

The treatment for blood in the urine will depend on the cause.

Treating UTIs usually involves antibiotic therapy. Stones in the urinary tract can pass on their own without treatment. Large stones may require medication to break them up or surgical removal.

People should contact their doctor if they experience severe symptoms that interfere with their daily lives.

What is obesity and what causes it?

Calories Sedentary lifestyle Not sleeping enough Endocrine disruptors Medications Is obesity self-perpetuating? Obesity gene Takeaway

Obesity is a medical condition that occurs when a person carries excess weight or body fat that might affect their health. A doctor will usually suggest that a person has obesity if they have a high body mass index.

Body mass index (BMI) is a tool that doctors use to assess if a person is at an appropriate weight for their age, sex, and height. The measurement combines height and weight.

A BMI between 25 and 29.9 indicates that a person is carrying excess weight. A BMI of 30 or over suggests that a person may have obesity.

Other factors, such as the ratio of waist-to-hip size (WHR), waist-to-height ratio (WtHR), and the amount and distribution of fat on the body also play a role in determining how healthy a person’s weight and body shape are.

If a person does have obesity and excess weight, this can increase their risk of developing a number of health conditions, including metabolic syndrome, arthritis, and some types of cancer.

Metabolic syndrome involves a collection of issues, such as high blood pressure, type 2 diabetes, and cardiovascular disease.

Maintaining a healthy weight or losing through diet and exercise is one way to prevent or reduce obesity. In some cases, a person may need surgery.

Now read on to find out why obesity happens.

1) Consuming too many calories

When a person consumes more calories than they use as energy, their body will store the extra calories as fat. This can lead to excess weight and obesity.

Also, some types of foods are more likely to lead to weight gain, especially those that are high in fats and sugars.

Foods that tend to increase the risk of weight gain include:

  • fast foods
  • fried foods, such as french fries
  • fatty and processed meats
  • many dairy products
  • foods with added sugar, such as baked goods, ready-made breakfast cereals, and cookies
  • foods containing hidden sugars, such as ketchup and many other canned and packaged food items
  • sweetened juices, sodas, and alcoholic drinks
  • processed, high-carb foods, such as bread and bagels

Some processed food products contain high-fructose corn syrup as a sweetener, including savory items, such as ketchup.

Eating too much of these foods and doing too little exercise can result in weight gain and obesity.

A person who consumes a diet that consists mainly of fruits, vegetables, whole grains, and water is still at risk of gaining excess weight if they overeat, or if genetic factors, for example, increase their risk.

However, they are more likely to enjoy a varied diet while maintaining a healthy weight. Fresh foods and whole grains contain fiber, which makes a person feel full for longer and encourages healthy digestion.

2) Leading a sedentary lifestyle

Many people lead a much more sedentary lifestyle than their parents and grandparents did.

Examples of sedentary habits include:

  • working in an office rather than doing manual labor
  • playing games on a computer instead of doing physical activities outside
  • going to places by car instead of walking or cycling

The less a person moves around, the fewer calories they burn.

Also, physical activity affects how a person’s hormones work, and hormones have an impact on how the body processes food.

Several studies have shown that physical activity can help to keep insulin levels stable and that unstable insulin levels may lead to weight gain.

Researchers who published a review in BMJ Open Sport and Exercise Medicine in 2017 noted that, while the designs of some studies make it hard to draw exact conclusions, “A lifestyle incorporating regular [physical activity] has been identified as a key factor for maintaining and improving many aspects of health, including insulin sensitivity.”

Physical activity need not be training in the gym. Physical work, walking or cycling, climbing stairs, and household tasks all contribute.

However, the type and intensity of activity may affect the degree to which it benefits the body in the short- and long-term.

3) Not sleeping enough

Research has suggested that missing sleep increases the risk of gaining weight and developing obesity.

Researchers reviewed evidence for over 28,000 children and 15,000 adults in the United Kingdom from 1977 to 2012. In 2012, they concluded that sleep deprivation significantly increased obesity risk in both adults and children.

The changes affected children as young as 5 years of age.

The team suggested that sleep deprivation may lead to obesity because it can lead to hormonal changes that increase the appetite.

When a person does not sleep enough, their body produces ghrelin, a hormone that stimulates appetite. At the same time, a lack of sleep also results in a lower production of leptin, a hormone that suppresses the appetite.

4) Endocrine disruptors

A team from the University of Barcelona published a study in the World Journal of Gastroenterology that provides clues as to how liquid fructose — a type of sugar — in beverages may alter lipid energy metabolism and lead to fatty liver and metabolic syndrome.

Features of metabolic syndrome include diabetes, cardiovascular disease, and high blood pressure. People with obesity are more likely to have metabolic syndrome.

After feeding rats a 10-percent fructose solution for 14 days, the scientists noted that their metabolism was starting to change.

Scientists believe there is a link between high consumption of fructose and obesity and metabolic syndrome. Authorities have raised concerns about the use of high-fructose corn syrup to sweeten drinks and other food products.

Animal studies have found that when obesity occurs due to fructose consumption, there is also a close link with type 2 diabetes.

In 2018, researchers published the results of investigations involving young rats. They, too experienced metabolic changes, oxidative stress, and inflammation after consuming fructose syrup.

The researchers note that “increased fructose intake may be an important predictor of metabolic risk in young people.”

They call for changes in the diets of young people to prevent these problems.

Avoiding high-fructose corn syrup

Foods that contain high-fructose corn syrup include:

  • sodas, energy drinks, and sports drinks
  • candy and ice cream
  • coffee creamer
  • sauces and condiments, including salad dressings, ketchup, and barbecue sauce
  • sweetened foods, such as yogurt, juices, and canned foods
  • bread and other ready-made baked goods
  • breakfast cereal, cereal bars, and “energy” or “nutrition” bars

To reduce your intake of corn syrup and other additives:

  • check the labels before you buy
  • opt for unsweetened or less processed items where possible
  • make salad dressings and bake other products at home

Some foods contain other sweeteners, but these can also have adverse effects.

5) Medications and weight gain

Some medications can also lead to weight gain.

Results of a review and meta-analysis published in The Journal of Clinical Endocrinology and Metabolism in 2015 found that some medicines caused people to gain weight over a period of months.

  • atypical antipsychotics, especially olanzapine, quetiapine, and risperidone
  • anticonvulsants and mood stabilizers, and specifically gabapentin
  • hypoglycemic medications, such as tolbutamide
  • glucocorticoids used to treat rheumatoid arthritis
  • some antidepressants

However, some medications may lead to weight loss. Anyone who is starting a new medication and is concerned about their weight should ask their doctor whether the drug is likely to have any effect on weight.

6) Is obesity self-perpetuating?

The longer a person is overweight, the harder it may be for them to lose weight.

Findings of a mouse study, published in the journal Nature Communications in 2015, suggested that the more fat a person carries, the less likely the body is to burn fat, because of a protein, or gene, known as sLR11.

It seems that the more fat a person has, the more sLR11 their body will produce. The protein blocks the body’s ability to burn fat, making it harder to shed the extra weight.

7) Obesity gene

A faulty gene called the fat-mass and obesity-associated gene (FTO) is responsible for some cases of obesity.

A study published in 2013 points to a link between this gene and:

  • obesity
  • behaviors that lead to obesity
  • a higher food intake
  • a preference for high-calorie foods
  • an impaired ability to feel full, known as satiety

The hormone ghrelin plays a crucial role in eating behavior. Ghrelin also affects the release of growth hormones and how the body accumulates fat, among other functions.

The activity of the FTO gene might impact a person’s chances of having obesity because it affects the amounts of ghrelin a person has.

In a study involving 250 people with eating disorders, published in Plos One in 2017, researchers suggested that aspects of FTO might also play a role in conditions, such as binge eating and emotional eating.

Takeaway

Many factors play a role in the development of obesity. Genetic traits can increase the risk in some people.

A healthful diet that contains plenty of fresh food, together with regular exercise, will reduce the risk of obesity in most people.

However, those that have a genetic predisposition may find it harder to maintain a healthy weight.

Yoga keeps the mind and body young, 22 clinical trials show

A review analyzing the results of 22 randomized clinical trials has found that yoga practice can improve many aspects of physical and mental health among older adults.

Yoga can be an effective option for older adults who want to maintain good physical and mental health. Yoga refers to a series of mind-body practices that originate in Hindu tradition.However, they are growing in popularity across the world as an alternative well-being practice. Statistic show that in 2015 in the United States alone, as many as 36.7 million people practiced yoga, and by 2020, estimates suggest that this number will have increased to over 55 million people. This is an amazing for population’s general health

People who practice yoga often share anecdotes regarding its beneficial effect on their mental and physical health. Intrigued by such reports, some scientists set out to verify whether the benefits are real.

Indeed, some studies have found that different yoga practices are able to improve a person’s general sense of well-being, as well as various aspects of their physical health.

For example, a series of studies from 2017 suggested that people who joined a yoga program experienced lower levels of anxiety and depression.

A study from 2016 found that practicing yoga correlated with a lower risk of cognitive impairment in older adults, and research from earlier this year concluded that 8 weeks of intense yoga practice reduced the symptoms of rheumatoid arthritis.

Now, investigators at the University of Edinburgh in the United Kingdom have conducted a review, analyzing the findings of 22 randomized and cluster-randomized clinical trials that assessed the benefits of yoga practice for healthy older adults.

The trials considered the effects of varied yoga programs — with program durations between 1 and 7 months and individual session durations between 30 and 90 minutes — on both mental and physical well-being.

‘Yoga has great potential’ to improve health

In the review, which features as an open access article in the International Journal of Behavioral Nutrition and Physical Activity, the researchers conducted statistical analysis to assess the combined findings of the 22 trials. They compared the benefits associated with yoga with those of other light physical activities, such as walking and chair aerobics. The team found that among people with a mean age of 60 years or over, practicing yoga — compared with not engaging in physical activity — helped improve their physical balance, flexibility of movement, and limb strength. It also reduced depression, improved sleep quality, and boosted their vitality.

Also, the researchers noticed that older adults who practiced yoga perceived their own physical and mental health to be satisfactory.

When compared with other light physical activities, such as walking, yoga seemed to more effectively improve older adults’ lower body strength, enhance their lower body flexibility, and reduce their symptoms of depression.

A large proportion of older adults are inactive and do not meet the balance and muscle strengthening recommendations set by government and international health organizations.

However, yoga can be an easy, adaptable, and attractive form of physical activity, and since the evidence suggesting that it can be beneficial for health is building up, joining a yoga program could be a good option for older adults looking to stay in shape — both physically and mentally.

Based on this study, we can conclude that yoga has great potential to improve important physical and psychological outcomes in older adults. Yoga is a gentle activity that can be modified to suit those with age-related conditions and diseases.

Does CBD oil work for chronic pain management?

Effects What is CBD oil? Benefits for pain treatment Other uses Dosage Side effects Other considerations Takeaway

While many people use cannabidiol to relieve pain, more scientific research is needed to be sure it is safe. Understanding cannabidiol can help overcome the stigma associated with it.

Some people experience side effects when taking cannabidiol (CBD) and there are other factors to consider before using CBD oil for pain.

In this article, we look at how CBD oil works and how people can use it to relieve chronic pain.

Effects

CBD is one of more than 120 compounds called cannabinoids.Many plants contain cannabinoids, but people most commonly link them to cannabis.

Unlike other cannabinoids — such as tetrahydrocannabinol (THC) — CBD does not produce a euphoric “high” or psychoactive effect. This is because CBD does not affect the same receptors as THC.

The human body has an endocannabinoid system (ECS) that receives and translates signals from cannabinoids. It produces some cannabinoids of its own, which are called endocannabinoids. The ECS helps to regulate functions such as sleep, immune-system responses, and pain.

When THC enters the body, it produces a “high” feeling by affecting the brain’s endocannabinoid receptors. This activates the brain’s reward system, producing pleasure chemicals such as dopamine.

Does CBD make you high?

CBD is an entirely different compound from THC, and its effects are very complex. It is not psychoactive, meaning it does not produce a “high” or change a person’s state of mind, but it influences the body to use its own endocannabinoids more effectively.

According to one study posted to Neurotherapeutics, this is because CBD itself does very little to the ECS. Instead, it activates or inhibits other compounds in the endocannabinoid system.

For example, CBD stops the body from absorbing anandamide, a compound associated with regulating pain. So, increased levels of anandamide in the bloodstream may reduce the amount of pain a person feels.

Cannabidiol may also limit inflammation in the brain and nervous system, which may benefit people experiencing pain, insomnia, and certain immune-system responses.

What is CBD oil?

There are different levels of compounds found in the natural hemp or cannabis plant. How people breed the plant affects the CBD levels. Most CBD oil comes from industrial hemp, which usually has a higher CBD content than marijuana.

Makers of CBD oil use different methods to extract the compound. The extract is then added to a carrier oil and called CBD oil.

CBD oil comes in many different strengths, and people use it in various ways. It is best to discuss CBD oil with a doctor before using it.

Benefits

People have used CBD traditionally used for thousands of years to treat various types of pain, but the medical community have only recently begun to study it again.

Here are some of the possible benefits of CBD oil:

Arthritis pain

CBD oil is popular for easing pain associated with arthritis.

A study in the European Journal of Pain used an animal model to see if CBD could help people with arthritis manage their pain. Researchers applied a topical gel containing CBD to rats with arthritis for 4 days.

Their researchers note a significant drop in inflammation and signs of pain, without additional side effects.

People using CBD oil for arthritis may find relief from their pain, but more human studies need to be done to confirm these findings.

Multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease that affects the entire body through the nerves and brain.

Muscle spasms are one of the most common symptoms of MS. These spasms can be so great they cause constant pain in some people.

One report found that short-term use of CBD oil could reduce the levels of spasticity a person feels. The results are modest, but many people reported a reduction in symptoms. More studies on humans are needed to verify these results.

Chronic pain

The same report studied CBD use for general chronic pain. Researchers compiled the results of multiple systematic reviews covering dozens of trials and studies. Their research concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults.

A separate study in the Journal of Experimental Medicine supports these results. This research suggests that using CBD can reduce pain and inflammation.

The researchers also found that subjects were not likely to build up a tolerance to the effects of CBD, so they would not need to increase their dose continually.

They noted that cannabinoids, such as CBD, could offer helpful new treatments for people with chronic pain.

Other uses

In the United States, CBD oil has varying legality across different states and at a federal level, yet it currently has a range of applications and promising possibilities.

These include:

  • smoking cessation and drug withdrawal
  • treating seizures and epilepsy
  • anxiety treatment
  • reducing some of the effects of Alzheimer’s, as shown by initial research
  • antipsychotic effects on people with schizophrenia
  • future applications in combating acne, type 1 diabetes, and cancer

Although more research is required to confirm some uses of CBD oil, it is shaping up as a potentially promising and versatile treatment.

In June 2018, the U.S. Food and Drug Administration (FDA) approved one form of CBD as a treatment for people with two rare and specific kinds of epilepsy, namely Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS).

The brand name of this drug is Epidiolex.

Dosage

The FDA does not regulate CBD for most conditions. As a result, dosages are currently open to interpretation, and people should treat them with caution.

Anyone who wishes to use CBD should first speak to a doctor about whether it is a good idea, and how much to take.

The FDA recently approved a purified form of CBD for some types of epilepsy, with the brand name Epidiolex. If you are using this medication, be sure to follow the doctor’s advice about doses.

Side effects

Most people tolerate CBD oil well, but there are some possible side effects.

According to a review in Cannabis and Cannabinoid Research, the most common side effects include:

  • tiredness
  • diarrhea
  • changes in appetite
  • weight gain or weight loss

In addition, using CBD oil with other medications may make those medications more or less effective.

The review also notes that scientists have yet to study some aspects of CBD, such as its long-term effects on hormones. Further long-term studies will be helpful in determining any side effects CBD has on the body over time.

People who are considering using CBD oil should discuss this with their doctors. Doctors will want to monitor the person for any changes and make adjustments accordingly.

The patient information leaflet for Epidiolex cautions that there is a risk of liver damage, lethargy, and possibly depression and thoughts of suicide, but these are true of other treatments for epilepsy, too.

CBD and other cannabinoids may also put the user at risk for lung problems.

One study in Frontiers in Pharmacology, suggested cannabinoids’ anti-inflammatory effect may reduce inflammation too much.

A large reduction in inflammation could diminish the lungs’ defense system, increasing the risk of infection.

Other considerations

Almost all research on CBD oil and pain comes from adult trials. Experts do not recommend CBD oil for use in children, as there is little research on the effects of CBD oil on a child’s developing brain.

People should consult a doctor if they think a child needs to use CBD oil for seizures.

CBD oil is also not recommended during pregnancy or while breast-feeding.

Takeaway

While many studies have suggested CBD oil is helpful for pain, more research is necessary, especially in long-term studies with human subjects.

However, CBD oil does show a lot of potential for pain relief. Anecdotal evidence suggests that it can be used to help manage chronic pain in many cases.

CBD oil is especially promising due to its lack of intoxicating effects and a possible lower potential for side effects than many other pain medications.

People should discuss CBD oil with their doctor if they are considering using it for the first time.

What to expect during IUD insertion

An intrauterine device or IUD is a small T-shaped device that a doctor or nurse can implant into the uterus to prevent pregnancy.

It is among the most effective forms of reversible birth control with a failure rate of less than 1%. The insertion is a minor medical procedure that only takes a few minutes.

Research has shown that while women report insertion experiences that range from painless to extremely painful, the procedure is usually less painful than they expected.

In this article, learn about what to expect during an IUD insertion. We also cover the side effects and recovery.

Preparation

Before getting an IUD, a person can speak to their doctor about which type is best for them. IUDs come in two forms:

  • The copper IUD: This version of the device kills sperm, preventing it from fertilizing an egg.
  • The hormonal IUD: This type of device releases progestin, which is very similar to progesterone, a hormone the body manufactures itself.

Progestin can prevent ovulation, which means there is no egg for the sperm to fertilize. It also thickens cervical mucus, making it more difficult for sperm to travel to the egg if the body does ovulate.

Hormonal IUDs may help with some premenstrual and hormonal symptoms, such as heavy bleeding or period cramps.

Copper IUDs do not offer any benefit other than contraception, so doctors do not usually recommend them for people who already experience heavy bleeding or severe cramps during menstruation.

IUDs are safe for most people to use. However, those who are allergic to copper should not use a copper IUD.

An IUD can prevent unwanted pregnancy but cannot protect against sexually transmitted infections (STIs).

People should not use an IUD if they have had any of the following:

  • abnormal vaginal bleeding
  • vaginal or cervical cancer
  • a recent pelvic infection or STI

Women who are pregnant or want to become pregnant should not get an IUD, although it is safe to get an IUD soon after childbirth.

In some people, progestin increases the risk of blood clots in the leg or high blood pressure, so it is vital to tell the doctor about any cardiovascular or other health problems.

Many people worry about pain during an IUD insertion. However, a recent study found that women’s self-reported pain, following IUD insertion, was significantly lower than the pain they expected to experience.

Some research suggests that anxiety before the procedure can make insertion feel more painful. Working with an empathetic doctor or nurse, who is willing to take time to discuss the procedure and offer reassurance, may help.

A person may wish to consider asking a doctor what previous experience they have of inserting IUDs. Similarly, they can tell the doctor if they are feeling nervous about what is going to happen.

Some people report that taking over-the-counter (OTC) pain medication, such as ibuprofen, before the procedure helps reduce pain afterward.

During the procedure

During the procedure, a person will remove their undergarments and other clothing from the waist down. They will then lie on their back, usually with their legs in stirrups. A doctor or nurse will offer a sheet to cover the thighs to help a person feel more comfortable and less exposed.

The doctor will first conduct a pelvic exam using the fingers, then cleanse the vagina and base of the cervix with an antiseptic solution.

They will then insert a speculum into the vagina to separate the walls, enabling them to see better. Using a small instrument, they will insert the IUD into the uterus through a small opening in the cervix.

Some people experience cramping similar to or sometimes more intense than menstrual cramps. If the pain feels unusual or unbearable, the person must tell the doctor. The whole process usually takes only a few minutes.

After the insertion

Some people feel dizzy or faint after an IUD insertion, so it can be a good idea to have someone accompany them for the journey home.

It is usually safe to return to work or school right away. However, if a person is feeling intense pain or cramping, they may wish to rest for a day.

Following insertion of an IUD, it is normal to notice some spotting. According to Planned Parenthood, spotting can last up to 3–6 months.

The individual should ask the doctor how long to wait before having unprotected sex. IUDs cannot prevent STIs, so it is important to practice safer sex with new or untested partners.

Aftercare

One of the main benefits of an IUD is that it requires no special care. In the days following insertion, it is common to experience some cramping and spotting. OTC medication can help reduce these symptoms. Any pain should disappear in a few days.

The IUD attaches to a string that enables a doctor or nurse to remove the device. Some women can feel the string with their fingers. It is best to leave it alone. The string is not dangerous but pulling it could move or even remove the IUD.

If the string causes irritation or if a partner can feel the string during sex, a person can ask a doctor to trim it.

In rare cases, an IUD can come out on its own. If this happens, it is possible for the person to become pregnant. Anyone whose IUD has fallen out should call a doctor and not have unprotected sex.

Side effects

Copper and hormonal IUDs can cause side effects, although these usually resolve after a few months.

Side effects of the hormonal IUD can include:

  • spotting
  • missed periods or no periods
  • headaches
  • bloating
  • nausea
  • breast tenderness
  • changes in breast size
  • mood swings
  • depression
  • low libido
  • weight gain

Not everyone experiences side effects or all of the above that doctors associate with IUDs.

Side effects of the copper IUD can include:

  • pain and cramping
  • a backache
  • long and heavy periods
  • irregular periods
  • spotting

Complications with an IUD are relatively rare, but can include:

  • the IUD falling out
  • problems associated with the hormonal IUD, such as changes in blood pressure or blood clotting.
  • an ectopic pregnancy, or pregnancy outside of the uterus
  • infection following insertion
  • pelvic inflammatory disease, if a person already has an infection before the IUD insertion
  • damage to the uterus

People with a history of cardiovascular disease, those who smoke, and those who are over 35 years old are more likely to have complications from a hormonal IUD.

It is a myth that IUDs can travel to other areas of the body, such as the brain or lungs.

Removal

IUDs can prevent pregnancy for 3 to 12 years and sometimes longer. It is possible to remove the IUD at any time.

During removal, a nurse or doctor will ask a person to lie on their back and put their feet in stirrups.

They will insert a speculum to open the vagina and then gently tug on the IUD string. This causes the IUD to fold and pass through the cervix. A person may experience cramping during removal, but the procedure only takes a few minutes.

Sometimes the IUD is harder to remove. If this happens, a doctor might use smaller instruments to take it out. Very rarely, if an IUD is stuck, a person may require surgery to remove it.

When to see a doctor

People should see a doctor if the following symptoms appear shortly after IUD insertion:

  • a fever above 101°F
  • chills
  • intense or unbearable cramping
  • strong, sharp pain in the stomach
  • very heavy bleeding

Call a doctor for these symptoms at any time after insertion:

  • a missed period with a copper IUD
  • a positive home pregnancy test
  • an IUD that falls out or seems to be coming through the cervix

Summary

An IUD is an excellent option for people who want long-term birth control without remembering to take pills, receive injections, or use condoms.

As with any birth control, IUDs offer both benefits and risks. If a person is unsure about whether it is the right choice for them, they can speak to a doctor to discuss their concerns.

The IUD insertion can be uncomfortable or painful for some people, but the pain usually passes. It may also cause some side effects as the body gets used to the new device.

It is best to speak with a doctor about any side effects if these interfere with a person’s overall well-being or quality of life.