Five Bullet Friday, New Research, Physical Therapy, The Latest Research in Pelvic Health

Five Bullet Friday: Women’s Health – January 3, 2020

Happy Friday!

Today’s Five Bullet Friday:

1. The Effects of Intermittent Fasting on Health, Aging and Disease – NEW Article in NEJM

2. Explaining Pain to Your Patients – A Physio’s Favourite Resource

3. Urinary and Gynaecological Dysfunctions Common with EDS and Associated Hypermobility Disorders

4. Global Consensus Guidelines on Use of Testosterone in Women (2019)

5. PATIENT HANDOUT: 5 Toileting Mistakes that Could Contribute to Pelvic Floor Dysfunction

Five Bullet Friday: Women’s Health is meant to be a quick, easy to skim resource for you and other health and medical professionals to keep you up to date with all things related to women’s health. My goal for these emails will be to bring to you pertinent and helpful resources for patients (such as short videos or handouts), new research and guidelines, clinical pearls, or anything else interesting related to women’s health! If you’d like to be added to my email list to receive my Five Bullet Friday: Women’s Health, or if you would like suggest particular topics you are eager to hear about, please send an email to cassie@tayloredtraining.ca.

Thank-you, and happy reading!

 

1. The Effects of Intermittent Fasting on Health, Aging and Disease – NEW Article NEJM

In this excellent review article in the New England Journal of Medicine, authors Cabo and Mattson discuss intermittent fasting and its many benefits for humans. They discuss previous nutrition animal studies that assumed that benefits came from calorie restriction, at the time not recognizing that the animals typically consumed their entire daily food allotment within a few hours after its provision, thus meaning they had a daily fasting period of up to 20 hours, during which ketogenesis occurs.

For humans, preclinical studies and clinical trials have shown that intermittent fasting has broad-spectrum benefits for many health conditions, such as obesity, diabetes mellitus, cardiovascular disease, cancers, and neurologic disorders. Positive outcomes from intermittent fasting extend past those of simply restricting calories and the beneficial effects involve metabolic switching and cellular stress resistance.

In this review article, it is recommended that physicians can advise patients to gradually reduce the time window during which they consume food each day with the goal of fasting for 16 to 18 hours a day. They can alternatively recommend another intermittent fasting protocol as outlined in the review.

Reference: De Cabo, R. & Mattson, M. New Engl J Med. 2019; 381: 2541-51. DOI: 10.1056/NEJMra1905136

 

2. Explaining Pain to Your Patients: a Physio’s Favourite Resource

One of my favourite resources to share with patients regarding why they experience pain and what to do about it comes from pain specialists in Australia. Check out the following video “Understanding Pain and What to Do About it in Less Than Five Minutes”

Check out this great resource, here!

 

3. Urinary and Gynaecological Dysfunctions Common with EDS and Associated Hypermobility Disorders

Ehlers-Danlos syndromes (EDS) and associated hypermobility spectrum disorders (HSD) are a group of connective tissue disorders associated with significant morbidity. A recent review suggests that in this population a higher index of suspicion for urorgenital problems is warranted in this population, with urinary, gynaecological and obstetrical complications reported as common.

This information is helpful to encourage early referrals to appropriate disciplines in this population, including pelvic health physiotherapists.

Reference: Gilliam, E, Hoffman, JD, Yeh, G. Urogenital and pelvic complications in the Ehlers‐Danlos syndromes and associated hypermobility spectrum disorders: A scoping review. Clin Genet. 2019; 1– 11. https://doi.org/10.1111/cge.13624

 

4. Global Consensus Guidelines on Use of Testosterone in Women (2019)

A Task Force of representatives of leading societies, whose international memberships include clinicians assessing and managing sex steroid therapy for women, was established in order to create a global consensus position statement on the use of testosterone in women. This Guideline was published in December 2019, it addresses available evidence and states:

  • No cut-off blood level can be used for any measured circulating androgen to differentials women with and without sexual dysfunction
  • There are insufficient data to make any recommendations regarding the use of testosterone in premenopausal women for treatment of sexual function or any other outcome
  • The only evidence-based indication for testosterone therapy for women is the treatment of HSDD, with available data supporting a moderate therapeutic effect, in postmenopausal women
  • There are insufficient data to support the use of testosterone for the treatment of any other symptom or clinical condition, or for disease prevention
Reference: Davis, Susan & Baber, Rodney & Panay, Nicholas & Bitzer, Johannes & Perez, Sonia & Islam, Rakibul & Kaunitz, Andrew & Kingsberg, Sheryl & Lambrinoudaki, Irene & Liu, James & Parish, Sharon & Pinkerton, Joann & Rymer, Janice & Simon, James & Vignozzi, Linda & Wierman, Margaret. (2019). Global Consensus Position Statement on the Use of Testosterone Therapy for Women. The Journal of Clinical Endocrinology & Metabolism. 104. 10.1210/jc.2019-01603.

 

5. Patient Handout: 5 Toileting Mistakes that Could Contribute to Pelvic Floor Dysfunction

Toileting habits are something we don’t often talk about but that can absolutely encourage or exacerbate pelvic floor dysfunctions. See attached to this email a great resource for patient’s talking about common toileting mistakes and what they can do to correct them!