Dr. Cynara Coomer

I am outraged with the recommendations from the U.S. Preventive Services Task Force. Not only does it send a mixed message to women about the benefits of a screening mammogram, it is also a dangerous practice to not screen women between the ages of 40-49 without an alternative test. Furthermore, early detection of breast cancer by mammograms has shown to have a significant decrease in the number of deaths. Although the numbers are more impressive for women over the age of 50, there is still a large impact for women in the 40-49 age group. For every 1,300 women screened between the ages of 50-59, one woman’s life is saved. For every 1,900 women screened between the ages of 40-49, one woman’s life is saved.  Is the difference in the ratio really worth denying women in their 40s a chance of survival?

Proponents of the task force’s recommendation argue that screening women in their 40s has led to a high number of false negatives, needless biopsies and unnecessary anxiety. However the impact of saving a woman’s life in my perspective outweighs these problems. Ultimately, we need to find more appropriate tests to screen women, but the mammogram is our best available modality at this time.

Because of the number of women under the age of 50 that I personally treat in my practice for breast cancer, I will not go against the American Cancer Society guidelines of starting mammograms at the age of 40. Depending on their risk factors, some women may need a baseline mammogram at the age of 35. The impact of these guidelines is not only about survival outcomes, it is also about the treatment options that are available when breast cancer is found early. When breast cancer is found at an early stage, there are more surgical options and it usually does not require the addition of chemotherapy. On the other hand, when cancer is found at a later stage, surgical options become more limited and treatment will most likely include radiation and chemotherapy. The prognosis is also worse when cancer is found at a later stage. So to think that costs will be lowered by decreasing the number of screening tests does not make sense when we risk diagnosing breast cancer at a later stage. In the end, the cost of treating advanced breast cancer is far more expensive.

I hope the task force reconsiders and reverses their recommendation so that women will continue to understand that mammograms starting at the age of 40 save lives.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

Dr. Cynara Coomer

The most common surgery for breast cancer these days is a lumpectomy, which is considered breast-conserving therapy. If patients choose to undergo this surgery, it has to be combined with radiation therapy, which can be administered in the form of external radiation, where the whole breast is radiated, or partial breast radiation called brachytherapy.

Another option for surgically treating breast cancer is by mastectomy. Mastectomies remove all the breast tissue, but nowadays, most women are candidates for immediate breast reconstruction done during the same operation.

When reconstruction is used, women can have either a skin-sparing, areola-sparing, or nipple-sparing mastectomy. This is where the skin and/or the areola and nipple are preserved, which improves the cosmetic outcome dramatically. The type of breast cancer that a woman has will determine which of these procedures is appropriate.

Reconstruction can be performed by using implants or tissue transplanted from other areas of the body. Most commonly, abdominal fat is used, which results in a tummy tuck.

Some patients may need to have chemotherapy prior to surgery. Although this is not proven to improve the survival outcomes, it increases the surgical options and may potentially decrease the risk of local recurrence in the breast.

There are so many more options for women these days for surgically treating breast cancer, and they should be discussed with a breast surgeon.

Dr. Cynara Coomer is an assistant professor of surgery specializing in breast health and breast cancer surgery at Mount Sinai Medical Center in New York City. She is a FOX News Health contributor providing medical expertise on a variety of topics in cancer research with a focus on women’s health, breast diseases and tips for healthy breasts at any age.

Dear Yvonne,
Would you agree that it’s important for women not to worry about the way they look during sex? After all, research shows that a woman’s partner is likely paying attention to her face and body and looking for clues that she’s feeling really good, which makes him feel good, right?
— Charlie

Dear Charlie,
It’s hard for a man to gauge a woman’s sexual responsiveness. So he’s looking to her face for cues that she’s aroused, plus he’s titillating himself in seeing her “sex face” come to life. His ego goes into full gear in loving that he’s helping to make that happen for her — and he thinks it’s one of the hottest looks around. Even if a woman feels silly or is self-conscious about the way she looks, she should rest assured that he thinks she’s super sexy in that state.

Dear Yvonne,
Are men more interested in sex than women?
—Manny

Dear Manny,
Though this is the general thought, it’s not the general rule, as many women would contest. The idea that men have a stronger sex drive and more sexual interest than women is largely due to society traditionally having been more permission-giving with the male libido and pursuits. The true difference lies in when the sexes are interested in sex.

A woman’s sex drive is related to her menstrual cycle. For many women, it’s heightened during ovulation whereas for others it’s the week she’s menstruating. For males, his sex drive varies more daily versus monthly, and is dependent upon testosterone levels. A male’s testosterone levels tend to be highest in the morning.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Dear Doc,
When we hear about people being attracted to another’s feet, for example, the foot fetish, it always seems to be men who are into them. Do women, in general, find men’s feet sexually attractive?
—Bill

Dear Bill,
In general, there’s the stereotype that men’s feet aren’t attractive, especially if he’s past a certain age, and that men’s feet smell in large part because of a lack of attention. While your average female is not expecting him to become a metrosexual with the regular pedicure, or to have attractive feet per se, her biggest expectation/hope is that he will keep them clean. She wants him to wash them with warm soap and water, to trim his toenails and clean under them, and to make efforts to reduce dirt and the chance of fungal infections.

That said, women do notice men’s feet, but are usually more caught up in gauging his facial expressions and other body language when it comes to reading his potential attraction/feelings for her. Unkempt feet aren’t a dealbreaker for most, as she’ll excuse that he’s “just being a guy,” and add it to her mental checklist of things to touch up about him as they get more serious.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Dear Dr. Fulbright,
I’m a 54-year-old man, divorced and dating again, and find that older women who are into menopause or post-menopause have different attitudes about sex and their own sexuality.  When I was a teen, I was the “hunter.” Now, in middle age and single, I find myself being “the hunted.”  Women who can no longer have children also seem to be more sexual now in their later years. Your thoughts?  —Mark

Dear Mark,
There are a couple of major things going on when it comes to older women being seemingly more “aggressive” with their sexual relationships. First, with some widowed or divorced women, their quest is to find a partner for their later years. In some cases, there is the need or hope for financial support. For others, fear of loneliness is a driving factor. Knowing that the pickings get slimmer with every passing year, they’re going to be that much more assertive with the men they come across.

Second, between education, media programming, and simply the times, many older women are embracing their sexuality as never before. They’re not afraid to see themselves as sexual — and flaunt it. They love the fact that they no longer have to worry about getting pregnant, PMS, menstruation, birth control or raising children. In so many ways, they’re free when it comes to responding to their sexual urgings.

Do you have a question about sex? If so, foxnewshealth.com wants to hear from you! E-mail your questions to drmanny@foxnews.com

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Dear Dr. Y,
How can a man boost his partner’s confidence when it comes to her breasts?
—Scott

Dear Scott,
I think that the best thing a man can do is to tell her that her breasts are perfect. This is most effectively done when he’s cupping them during sex, admiring them like they’re the only part of her body he needs to feel satisfied.

If he feels that he can’t be totally sincere with the “perfect” bit, he should seize the opportunity to compliment her chest the next time she’s wearing an outfit that shows them off, for example, “You look absolutely stunning in that dress — I love how it shows off your breasts.” In accentuating them, he’s letting her know that she’s lovely in his book.

Also, when it comes to gift-giving time, he can get her presents that are about showing off her breasts, for example, a peek-a-boo bra that screams “play with me!”

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Dear Yvonne,
I read your recent article on sex headaches. Can’t sex also act as a type of headache medicine? I want something to say the next time my wife tells me she’s not in the mood because she has a “headache.”
—Chris

Dear Chris,
Yes, people often have sex to get rid of headaches. A 2007 study conducted at the University of Texas, evaluating students’ motivations for sex, confirmed as much. This is not surprising since research from The Journal of Head and Face Pain in 2001 found that orgasms during sexual intercourse can provide migraine relief for women. While the efficacy of orgasm isn’t nearly as good as taking a migraine medication, relief is provided much faster when effective.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Dear Yvonne,
I am a 50-year-old-man who has lost all interest in — and avoided — sex with my partner since she has gained weight. Watching her gobble a double pie a la mode for a nighttime snack was like an anti-Viagra for me. When I met her 3 years ago, she was perhaps 30 pounds thinner. I noticed an older photo of her and she appeared to be perhaps 50 pounds heavier. Do women lose weight to meet a man and seek commitment as if crossing a finish line to find the food again?
—JK 

Dear JK,
Both men and women often seek to be physically fit in order to attract a potential partner. Many do “let themselves go” once they have the commitment since they feel that the woo’ing phase of the relationship no longer requires work. However, it’s hard to say, if your partner intentionally lost weight to “nab” you, and then didn’t have a care in the world when she put the weight back on.

The reasons why people put on weight are very complicated and numerous. Factors that lead to weight gain include:

          o Diets high in calories (sodas), saturated fat (fried foods), and/or sugar (candy)
          o A lack of exercise
          o Not getting enough sleep
          o Stress
          o Health problems, for example, hypothyroidism
          o Medications
          o Menopause

In order to reclaim your sex life, try to spend quality time with your lover in ways that keep both of you active and eating healthy meals. Instead of being critical, try to be compassionate by expressing concern for her health, and offer to be of assistance in any way possible. Feeling sorry for yourself won’t do you or her any good.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

Eighty-five percent of the women in the United States experience hot flashes as they approach menopause. Researchers suggest that women with higher body weights actually have more hot flashes that their leaner counterparts. It is believed that hot flashes may be the body’s attempt at dispersing heat, but unfortunately fat seems to act as insulation that prevents the heat from spreading, which usually causes overheating to take place.

Therefore, studies have shown that women who followed a low-fat diet high in fiber-filled foods like fruits, vegetables and whole grains experienced fewer hot flashes than women who didn’t. Below is a list of foods that can help you reduce your symptoms:
 
1. Fiber: Recent research has suggested that no other method enhancing regularity has the same effect as fiber.  Fiber absorbs the estrogen, which relieves hot flashes by reducing the amount of estrogen reabsorbed from bile salts released into the intestine to be mixed with stool. It is recommended that women should be consuming 25-30 grams of fiber daily. Enjoy fiber-rich foods throughout the day such as whole grain breads and cereals, apples, pears, broccoli and cauliflower. 

2. Calcium: The National Institutes of Health recommends that menopausal women get 1,000 mg of calcium daily. Calcium cleanses excess estrogen from the liver, making this nutrient vital in reducing hot flashes.  Calcium-rich foods include low-fat milk, low-fat yogurts and low-fat cheeses. 

3. Soy: Recent studies have found that soy, which is rich in phytoestrogens like isoflavones, can also help reduce hot flashes, as well as night sweats and other menopausal symptoms. Opt for tofu, edamame or any other variety of soy beans, as well as low-fat soy yogurts and cheeses.

4. Beans: Almost all beans — not just soy — contain two important compounds; genistein and daidzein.  Which are known for being estrogenic, helping to control hot flashes and other discomforts of menopause.

5. Omega-3 Fatty Acids: New research from the American Journal of Clinical Nutrition shows a common food compound found in omega-3s can ease hot flashes. Salmon, shrimp, walnuts and tofu all contain high levels of omega-3s. 

6. Vitamin E: According to the National Cancer Institute, studies suggest increasing your intake of vitamin E. Vitamin E replenishes necessary electrolytes lost through perspiration during hot flashes.  Mango, sweet potatoes, almonds, peanuts and sunflower seeds are all great sources of vitamin E.

7. Vitamin B: This essential vitamin has been shown to help reduce hot flashes.  Foods like bananas, pistachios, fish, meat, eggs, bananas, beans and whole grains are all wonderful sources of vitamin B.

8. Vitamin C: One study showed that increasing your intake of vitamin C which contains bioflavonoids; a powerful antioxidant, reduced hot flashes. Grapefruit, oranges, potatoes, broccoli and pineapple are all fabulous sources of vitamin C.

9. Water: Drink a lot of water. Drinking water restores fluids lost to perspiration during hot flashes and can even prevent or minimize the hot flashes themselves.

10. Foods to avoid: Certain foods like, alcohol, caffeine, excess sugar, high-fat meat products and spicy foods rank among the top aggravators of these frustrating episodes.

Tanya Zuckerbrot, MS, RD is a nutritionist and founder of Skinnyandthecity.com.    She is also the creator of The F-Factor Diet™, an innovative nutritional program she has used for more than ten years to provide hundreds of her clients with all the tools they need to achieve easy weight loss and maintenance, improved health and well-being.  For more information log onto www.FFactorDiet.com.