Psoriasis Guide: Your Prescription for Psoriasis Treatment Information

Psoriasis is a condition that can cause discomfort, pain and emotional stress. We have put together this Guide to address this condition and answer some of the questions you may have about psoriasis, and how you can find relief. We have provided information on the basics of psoriasis, what should be avoided and help on general skin care, and diet information. You will also find research on some of the new and latest treatments, various therapies, and creams available for treating psoriasis.
Psoriasis treatment options range from topical and oral treatments, to light therapy. A person’s psoriasis can be mild and localized or be very extensive and have numerous symptoms. There are many types of psoriasis conditions including psoriatic arthritis, plaque psoriasis (psoriasis vulgaris), scalp psoriasis, guttate psoriasis, inverse psoriasis, pustular psoriasis, erythrodermic psoriasis, and nail psoriasis. This guide has information that addresses all of these conditions.

Treatment Of Scalp Psoriasis Topical Therapy : Topical therapy includes corticosteroids, calcipotriol / calcipotriene, tazarotene, tars, and anthralin. Tars and anthralin are discussed above. If the psoriasis is thick, measures must be taken to thin down the plaques. Since creams and ointments are hard to apply to the scalp and wash out of the hair, they are rarely used to treat scalp psoriasis. Lotions, solutions, and gels are generally used since they are easier to apply, and do not give a greasy appearance to the hair, and are easier to wash out.
Topical Corticosteroids : Topical corticosteroid gels, lotions, solutions, oils, and shampoos may be used to treat scalp psoriasis. They work quite quickly, often within 1-2 weeks however, with long-term use, steroids often lose their effectiveness.
The scalp solution may be easily applied to the scalp, the onset of action is usually slower (could take up to 2 months) than with topical steroids, but it is usually effective and safe for long term use. Since it may cause irritation, you should take care to limit application to your scalp and avoid use on your face.
Example of topical calcipotriol/calcipotriene scalp solution : Calcipitriol scalp solution (Dovonex®) Topical Tazarotene. Tazarotene is a selective retinoid with properties that are similar to vitamin A. The gel formulation is generally applied once daily overnight to the scalp patches, it can be easily worked into your scalp. Scalp irritation may occur with this product, but less commonly than elsewhere. To minimize irritation, apply a thin layer of the medication only to the patches and avoid the uninvolved surrounding skin. You should not use this medication if you are pregnant.
Systemic Therapy : Most of the time, oral medications are not required for scalp psoraisis, but if you have a very resistant case or if your itch is uncontrollable, they may be used.
Methotrexate : Methotrexate is usually given once a week orally (pills) or occasionally by injection (with a needle). It helps control psoriasis affecting your skin, nails, and joints. Side effects include upset stomach, mouth ulcers, suppression of the bone marrow with low blood counts, and liver damage. Careful monitoring by your physician is essential on this medication. Liver biopsies may be required.
Acitretin : Acitretin is a retinoid with properties similar to vitamin A. For most patients, it does not appear to be as effective as methotrexate or cyclosporine in the treatment of plaque psoriasis. However, it works quite well for pustular psoriasis. Side effects include dryness of your skin, lips, eyes, and nose, elevation of your cholesterol and triglyceride levels, liver toxicity, and bone changes. Since it may cause birth defects, it is used mainly in men, and women who are post-menopausal or have had a hysterectomy. Monitoring by your doctor, and regular blood tests are required while taking this medication.
Cyclosporine : Cyclosporine is an immunosuppressant medication that is used in organ transplantation. It is very effective, but because of its cost and side effects (kidney toxicity, high blood pressure, numbness and tingling, hair growth, skin cancer, and lymphomas), it is usually reserved for people with severe, disabling, resistant disease. Careful monitoring by your doctor is required while taking this medication.

Herpes Guide: How do I know if I have herpes?

Welcome to Herpes Guide, a member of the Skin Care Guide network of websites, written by international dermatologists. Did you know that herpes virus infections are common in both men and women? We hope you find answers to your questions about herpes in this Guide, which explores the various types of herpes, including Herpes Simplex Virus and herpes in pregnancy.
We have developed this site to help you understand the basics of herpes, how it is diagnosed, the role of cold sores and which drugs are effective in treating herpes. Take the time now to browse through our links and learn more about herpes.
There are now several drugs available in Canada to treat herpes, such as acyclovir (Zovirax®), valacyclovir (Valtrex®), famciclovir (Famvir®), penciclovir (Denavir®), ganciclovir (Cytovene®, Vitrasert®), vidarabine (Vira-A®), cidofovir (Vistide®), and foscarnet (Foscavir®). These prescription drugs come in different formulations such as topical, oral and intravenous formulations. There is also a drug for cold sores that you can buy without a prescription called docanosol cream (Abreva®). Your physician will help in recommending an appropriate regimen for your specific circumstance.
Acyclovir Acyclovir and its related compounds, valacyclovir, famciclovir, and penciclovir, remain the first line drugs of choice for the treatment of herpes simplex infections. Acyclovir is available in an oral, an intravenous, and a topical formulation. Valacyclovir and famciclovir are only available in oral form and not approved in Canada for use in children. Unfortunately only 10-20% of acyclovir is absorbed when taken orally. In contrast, valacyclovir is 80% absorbed and then converted to acyclovir in the liver.
Acyclovir is a “nucleoside analogue” (it can insert itself into virus DNA during virus replication) and specifically targets virus infected cells. It prevents the production of new virus by stopping viral DNA from properly forming. Famciclovir and valacyclovir work in a similar manner to acyclovir. Because of the way they act, these 3 drugs require the virus to reactivate in order to be effective. Therefore, they are only effective against virus that has escaped from the nerve-cell and is replicating in other parts of the body. Thus, they do not cure a ‘dormant’ (latent) HSV infection, since the latent virus is not replicating. There is no antiviral treatment available that can eradicate latent HSV infection.
Read about advantages and disadvantages of Acyclovir treatment.
Vidarabine, one of the first HSV antiviral drugs available, is less safe than acyclovir and is only used in a 3% ointment form in North America, as treatment against herpes infections of the eye.
Foscarnet Foscarnet, another of the early anti-herpes drugs, was only used in life threatening HSV infection due to toxicity. It is now used in serious HSV infection if acyclovir does not work.

Eczema Guide: Your Prescription for Eczema Treatment Information

Eczema is a chronic, recurring, intensely itchy, inflammation of the skin, which usually starts in early childhood. It is also known as atopic eczema or atopic dermatitis.
Taking a sensible approach to treating eczema is very important, so we have designed this site to help you understand your eczema more clearly. It discusses what eczema is, what causes eczema and what eczema treatment options are available. You will find out about cosmetic and skin care for your eczema, including how important moisturizing is. Different types of eczema are discussed including hand eczema, contact dermatitis, allergic dermatitis and others, and a selection of eczema pictures are available. There are also a number of topical and oral eczema treatments available that will help your eczema, including new classes of drugs and medical procedures like light therapy. If you have adult eczema, or your child has baby eczema or infant eczema, we encourage you to read this site and discuss your options with your physician.

Acne Guide: Your Source for Acne Care and Treatment

Acne, oftens thought to be only a teenager’s skin problem, is actually a condition that can affect adults both male or female, although it generally begins during puberty. Taking a proactive approach to treating acne is very important. Your daily skin care regime, along with the acne treatment or product you and your dermatologist select, are key steps in your fight to eliminate pimples and curing acne.
This site was designed to help you understand your skin condition more clearly, define the different types of acne, to provide information about preventing acne scarring and maintaining acne control, and to help cure it with acne medication. You will find out about the medical acne treatments that are available, as well as cosmetic and skin care for your acne prone skin. We also list various acne remedies and acne medicines that are available including over-the-counter acne products, prescription drugs including creams, oral treatments and hormone therapies.
If you have pimples, we encourage you to find a solution by seeking acne treatment early. You will be happier with your skin, and you may be able to prevent scars from developing in the future. If you already have acne scars, this site will also examine the treatment options currently available to reduce or remove scarring, such as microdermabrasion or laser skin resurfacing.

Treatments for Unwanted Facial Hair

Unwanted facial hair (UFH) in women is a common problem, and is most often a result of ethnic background or heredity. In a small percentage of women, it may be caused by androgen overproduction, increased sensitivity to circulating androgens, or other metabolic and endocrine disorders. Approximately 22% of women are affected by the presence of UFH growth on the mustache and chin area, and this can be a source of distress, leading to anxiety, depression and a reduced quality of life.1
It is very important to determine the underlying causes. Most are ethnic or hereditary; however, one must rule out any signs of androgen excess, e.g., an increase in body hair, irregular menstrual cycles, acne, alopecia, and seborrhea.
Polycystic Ovary Syndrome (PCOS) is the most common cause of androgen excess, and 70%-80% of patients with androgen excess demonstrate hirsutism, though this sign may be less prevalent among women of Asian extraction. There is a strong familial predilection for hirsutism, primarily because the underlying endocrine disorders in this population and the factors regulating the development of hair growth have a strong genetic component.2
Patients should be adequately advised of the available treatment modalities for hair removal. No single method of hair removal is appropriate for all body locations or patients, and the one adopted will depend on the character, area and amount of hair growth, as well as on the patient's age and their personal preference.3
Treatment options for removing excess facial hair are limited and can vary in effectiveness, the degree of discomfort, and cost. Current methods for removing this unwanted hair include such over-the-counter methods as plucking, waxing (including the sugar forms), depilatories, shaving, and home electrolysis. Hair removal methods that could take place in a doctor's office include laser, and intense pulsed light (IPL). An additional modality is a topical cream that inhibits hair growth: eflornithine 13.9% cream (Vaniqa®, Barrier Therapeutics in Canada and Shire Pharmaceuticals elsewhere).1
These methods are temporary with the time of regrowth ranging from a few days to a few months. For hirsutism associated with PCOS, treatments include oral contraceptives and/or antiandrogens, such as spironolactone, cyproterone acetate, flutamide and finasteride.4
Eflornithine HCl 13.9% cream is an irreversible inhibitor of ornithine decarboxylase, an enzyme that has been associated with the prolongation of the anagen or growth phase of the hair.6 Consequently, it reduces the rate of hair growth for all hairs. It appears to be effective regardless of whether the unwanted facial hair is hereditary or is due to medical conditions such as an androgen excess disorder, e.g., PCOS. After 24 weeks of treatment in clinical trials, it was shown to be effective on the chin and upper lip.7
Eflornithine, also known as difluoromethylornithine or DFMO, was synthesized in the 1970s as a potential anticancer drug. In 1980, Bacchi, et al. reported that this drug was effective in the treatment of African trypanosomiasis in a mouse model,8 and this finding later led to clinical studies in humans. In 1990, the US FDA granted marketing approval and orphan drug status for eflornithine to treat this disease. Clinical observations identified hair loss as a side-effect of eflornithine therapy and led to the development of Vaniqa®, which gained US regulatory approval in July 2001, as the first and only prescription cream clinically proven to slow the growth of unwanted facial hair in women.9

New and Effective Treatments for Warts

Warts are caused by viral infections of the skin. The information about these viruses are explained on www.skincareguide.ca/glossary/w/warts.html. In some cases warts are just a nuisance, but warts can be unsightly and can interfere with work when they affect the hands or feet. Certain occupations - notably butchers - tend to develop warts on the hands which are thought to be related to their work. Warts on the hands can be a problem for those who work closely with the public, for example servers, nurses, doctors and dentists. Warts on the feet can hobble letter carriers, and interfere with sports like golf and hockey.
Until recently, the only treatment for warts was to burn the warts off, either with caustic chemicals or with high frequency electric current. Neither treatment was very reliable, and both treatments were quite unpleasant.

Sometimes warts go away without any treatment. When this happens, it is thought to result from activation of the immune system, causing recognition and destruction of the warts. Over the past couple of years, researchers in the United States have shown that injections of Candida antigen (derived from a yeast) can often stimulate the immune system to recognize and attack warts which have been injected, and sometimes even other warts which were not injected. Because the injections are done using very fine needles, and there is no destruction of tissue, there is essentially no discomfort or cosmetic disability. In some cases, the warts need to be injected several times, two to four weeks apart. A cream called imiquimod (Aldara®) which is used mainly for genital warts, can occasionally be effective when applied to other kinds of warts. It works by boosting the skin's immune system which attacks the virus.

Within the past year, a highly effective vaccine against the wart virus which is associated with carcinoma of the cervix has been developed, and it is hoped that this will be commercially available soon. Perhaps some day we will have protective vaccines (and perhaps even therapeutic vaccines) against the viruses which cause warts on the hands and feet.

Bitter Orange

Introduction
This fact sheet provides basic information about bitter orange—common names, uses, potential side effects, and resources for more information. The bitter orange tree is native to eastern Africa and tropical Asia. Today, it is grown throughout the Mediterranean region and elsewhere, including California and Florida. Bitter orange oil is used in foods, cosmetics, and aromatherapyA therapy in which the scent of essential oils from flowers, herbs, and trees is inhaled to promote health and well-being. products. Bitter orange oil from the tree's leaves is called petitgrain, and oil from the flowers is called neroli.
Common Names—bitter orange, Seville orange, sour orange, Zhi shi
Latin Names—Citrus aurantium

What It Is Used For
Bitter orange has been used in traditional Chinese medicineA whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi. and by indigenous people of the Amazon rainforest for nausea, indigestion, and constipation. Current uses of bitter orange are for heartburn, loss of appetite, nasal congestion, and weight loss. It is also applied to the skin for fungal infections such as ringworm and athlete's foot.

How It Is Used
The dried fruit and peel (and sometimes flowers and leaves) are taken by mouth in extracts, tablets, and capsules. Bitter orange oil can be applied to the skin.

What the Science Says
There is not enough scientific evidence to support the use of bitter orange for health purposes. Many herbal weight-loss products now use bitter orange peel in place of ephedra. However, bitter orange contains the chemical synephrine, which is similar to the main chemical in ephedra. The U.S. Food and Drug Administration banned ephedra because it raises blood pressure and is linked to heart attacks and strokes; it is unclear whether bitter orange has similar effects. There is currently little evidence that bitter orange is safer to use than ephedra.

Side Effects and Cautions
Because bitter orange contains chemicals that may speed up the heart rate and raise blood pressure, it may not be safe to use as a dietary supplementA product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements.. There have been reports of fainting, heart attack, and stroke in healthy people after taking bitter orange supplements alone or combined with caffeine. People should avoid taking bitter orange if they have a heart condition or high blood pressure, or if they are taking medications (such as MAO inhibitors), caffeine, or other herbs/supplements that speed up the heart rate. Due to lack of safety evidence, pregnant women should avoid products that contain bitter orange. Bitter orange oil used on the skin may increase the risk of sunburn, particularly in light-skinned people. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Bilberry

Introduction
This fact sheet provides basic information about bilberry—common names, uses, potential side effects, and resources for more information. Bilberry is a relative of the blueberry, and its fruit is commonly used to make pies and jams. It has been used for nearly 1,000 years in traditional European medicine. Bilberry grows in North America, Europe, and northern Asia.
Common Names—bilberry, European blueberry, whortleberry, huckleberry
Latin Names—Vaccinium myrtillus

What It Is Used For
Historically, bilberry fruit was used to treat diarrhea, scurvy, and other conditions. Today, the fruit is used to treat diarrhea, menstrual cramps, eye problems, varicose veins, venous insufficiency (a condition in which the veins do not efficiently return blood from the legs to the heart), and other circulatory problems. Bilberry leaf is used for entirely different conditions, including diabetes.

How It Is Used
The fruit of the bilberry plant can be eaten or made into extracts. Similarly, the leaves of the bilberry plant can be made into extracts or used to make teas

What the Science Says
Some claim that bilberry fruit improves night vision, but clinical studies have not shown this to be true. There is not enough scientific evidence to support the use of bilberry fruit or leaf for any health conditions.

Side Effects and Cautions
Bilberry fruit is considered safe. However, high doses of bilberry leaf or leaf extract are considered unsafe due to possible toxic side effects. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Astragalus

Introduction
This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. astragalus—common names, uses, potential side effects, and resources for more information. Native to China, astragalus has been used for centuries in traditional Chinese medicineA whole medical system that originated in China. It is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi.. In the United States, the herb gained popularity in the 1980s. There are actually over 2,000 species of astragalus; however, the two related species Astragalus membranaceus and Astragalus mongholicus are the ones primarily used for health purposes.
Common Name—astragalus, bei qi, huang qi, ogi, hwanggi, milk vetch
Latin Name—Astragalus membranaceus, Astragalus mongholicus

What It Is Used For
Historically, astragalus has been used in traditional Chinese medicine, usually in combination with other herbs, to support and enhance the immune system. It is still widely used in China for chronic hepatitis and as an adjunctive therapy in cancer. It is also used to prevent and treat common colds and upper respiratory infections. Astragalus has also been used for heart disease.

How It Is Used
The root of the astragalus plant is typically used in soups, teas, extracts, or capsules. Astragalus is generally used with other herbs, such as ginseng, angelica, and licorice.

What the Science Says
The evidence for using astragalus for any health condition is limited. Results from small or preliminary studies suggest that astragalus may benefit heart function and help the immune system fight infections. A few studies have shown potential benefits for using astragalus—in combination with another herb, glossy privet (Ligustrum lucidum)—as an adjunctive therapy for cancer. In general, however, these studies were not well designed. NCCAM-funded investigators are studying the effects of astragalus on the body, particularly on the immune system.

Side Effects and Cautions
Astragalus is considered safe for most adults. Its possible side effects are not well known because astragalus is generally used in combination with other herbs. Astragalus may interact with medications that suppress the immune system, such as the drug cyclophosphamide taken by cancer patients and similar drugs taken by organ transplant recipients. People should avoid using astragalus species such as "locoweed" that grow in the United States, as these other species may have different effects and side effects. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Aloe Vera

Introduction

This fact sheet provides basic information about aloe vera—common names, uses, potential side effects, and resources for more information. Aloe vera's use can be traced back 6,000 years to early Egypt, where the plant was depicted on stone carvings. Known as the "plant of immortality," aloe was presented as a burial gift to deceased pharaohs.

Common Names—aloe vera, aloe, burn plant, lily of the desert, elephant's gall
Latin Names—Aloe vera, Aloe barbadensis

What It Is Used ForTraditionally, aloe was used topically to heal wounds and for various skin conditions, and orally as a laxative. Today, in addition to traditional uses, people take aloe orally to treat a variety of conditions, including diabetes, asthma, epilepsy, and osteoarthritis. People use aloe topically for osteoarthritis, burns, and sunburns. Aloe vera gel can be found in hundreds of skin products, including lotions and sunblocks. The Food and Drug Administration (FDA) has approved aloe vera as a natural food flavoring

How It Is Used

Aloe leaves contain a clear gel that is often used as a topical ointment. The green part of the leaf that surrounds the gel can be used to produce a juice or a dried substance (called latex) that is taken by mouth.

What the Science Says

Aloe latex contains strong laxative compounds. Products made with various components of aloe (aloin, aloe-emodin, and barbaloin) were at one time regulated by the FDA as oral over-the-counter (OTC) laxatives. In 2002, the FDA required that all OTC aloe laxative products be removed from the U.S. market or reformulated because the companies that manufactured them did not provide the necessary safety data. Early studies show that topical aloe gel may help heal burns and abrasions. One study, however, showed that aloe gel inhibits healing of deep surgical wounds. Aloe gel does not prevent burns from radiation therapy. There is not enough scientific evidence to support aloe vera for any of its other uses.

Side Effects and Cautions

Use of topical aloe vera is not associated with significant side effects. Abdominal cramps and diarrhea have been reported with oral use of aloe vera. Diarrhea, caused by the laxative effect of oral aloe vera, can decrease the absorption of many drugs. People with diabetes who use glucose-lowering medication should be cautious if also taking aloe by mouth because preliminary studies suggest aloe may lower blood glucose levels. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Asian Ginseng

Introduction

This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. Asian ginseng—common names, uses, potential side effects, and resources for more information. Asian ginseng is native to China and Korea and has been used in various systems of medicine for many centuries. Asian ginseng is one of several types of true ginseng (another is American ginseng, Panax quinquefolius). An herb called Siberian ginseng or eleuthero (Eleutherococcus senticosus) is not a true ginseng.
Common Names—Asian ginseng, ginseng, Chinese ginseng, Korean ginseng, Asiatic ginseng
Latin Name—Panax ginseng

What It Is Used For

Treatment claims for Asian ginseng are numerous and include the use of the herb to support overall health and boost the immune system. Traditional and modern uses of ginseng include

Improving the health of people recovering from illness Increasing a sense of well-being and stamina, and improving both mental and physical performance Treating erectile dysfunction, hepatitis C, and symptoms related to menopause Lowering blood glucose and controlling blood pressure How It Is UsedThe root of Asian ginseng contains active chemical components called ginsenosides (or panaxosides) that are thought to be responsible for the herb's medicinal properties. The root is dried and used to make tablets or capsules, extracts, and teas, as well as creams or other preparations for external use.

What the Science Says

Some studies have shown that Asian ginseng may lower blood glucose. Other studies indicate possible beneficial effects on immune function. To date, research results on Asian ginseng are not conclusive enough to prove health claims associated with the herb. Only a handful of large clinical trials on Asian ginseng have been conducted. Most studies have been small or have had flaws in design and reporting. Some claims for health benefits have been based only on studies conducted in animals. NCCAM supports studies to better understand the use of Asian ginseng. Areas of recent NCCAM-funded research include Asian ginseng's interactions with other herbs and drugs and the herb's potential to treat chronic lung infection, impaired glucose tolerance, and Alzheimer's disease. Side Effects and CautionsWhen taken by mouth, ginseng is usually well tolerated. Some sources suggest that its use be limited to 3 months because of concerns about the development of side effects. The most common side effects are headaches and sleep and gastrointestinal problems. Asian ginseng can cause allergic reactions. There have been reports of breast tenderness, menstrual irregularities, and high blood pressure associated with Asian ginseng products, but these products' components were not analyzed, so effects may have been due to another herb or drug in the product. Asian ginseng may lower levels of blood sugar; this effect may be seen more in people with diabetes. Therefore, people with diabetes should use extra caution with Asian ginseng, especially if they are using medicines to lower blood sugar or taking other herbs, such as bitter melon and fenugreek, that are also thought to lower blood sugar. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Side Effects and Cautions

When taken by mouth, ginseng is usually well tolerated. Some sources suggest that its use be limited to 3 months because of concerns about the development of side effects. The most common side effects are headaches and sleep and gastrointestinal problems. Asian ginseng can cause allergic reactions. There have been reports of breast tenderness, menstrual irregularities, and high blood pressure associated with Asian ginseng products, but these products' components were not analyzed, so effects may have been due to another herb or drug in the product. Asian ginseng may lower levels of blood sugar; this effect may be seen more in people with diabetes. Therefore, people with diabetes should use extra caution with Asian ginseng, especially if they are using medicines to lower blood sugar or taking other herbs, such as bitter melon and fenugreek, that are also thought to lower blood sugar. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Can herbal health products and supplements cause other problems?

Yes. Herbal products and supplements may have other effects that aren’t listed in the box above. A few examples include the following:

* Glucosamine products may contain sodium. If you’re on a low-sodium diet, talk to your doctor before taking glucosamine.
* People who are allergic to shellfish may also be allergic to glucosamine. If you have a shellfish allergy, check with your doctor before taking glucosamine.
* Don’t drink alcohol if you take kava products. Kava can increase the effects of alcohol.
* The phytoestrogen black cohosh contains salicylates, so avoid it if you are sensitive to aspirin or other salicylates.

Also, you shouldn’t take more than the recommended dose of any herbal health product or supplement. The problems that these products can cause are much more likely to occur if you take too much or take them for too long.

Can herbal health products or supplements change the way prescription or OTC drugs work?

Yes. Herbal health products or supplements can affect the way the body processes drugs. When this happens, your medicine may not work the way it should. For example, St. John’s wort reduces the amount of certain drugs absorbed by the body. This may mean the drugs aren’t absorbed at high enough levels to help the conditions for which they are prescribed. This can cause serious problems.

You should be especially cautious about using herbal health products or supplements if you take a drug in one of the following categories:

* Drugs to treat depression, anxiety or other psychiatric problems
* Anti-seizure drugs
* Blood thinners
* Blood pressure medicine
* Heart medicine
* Drugs to treat diabetes
* Cancer drugs

If you take any of these drugs, talk to your doctor before taking any type of herbal product or supplement.

Do any health problems increase the danger of taking herbal products and supplements?

Yes. Herbal products and supplements may not be safe if you have certain health problems. You also may be at increased risk of problems from these products if you are elderly. Talk to your doctor before taking herbal products if you have any of the following health problems:

* Blood clotting problems
* Cancer
* Diabetes
* An enlarged prostate gland
* Epilepsy
* Glaucoma
* Heart disease
* High blood pressure
* Immune system problems
* Psychiatric problems
* Parkinson’s disease
* Liver problems
* Stroke
* Thyroid problems

If you are going to have surgery, be sure to tell your doctor if you use herbal products. Herbal products can cause problems with surgery, including bleeding and problems with anesthesia. Stop using herbal products at least 2 weeks before surgery, or sooner if your doctor recommends it.

What types of herbal products and supplements are available?

Hundreds of herbal products and supplements are available. They are advertised to treat just about any symptom. However, trustworthy evidence usually doesn’t exist to support these advertising claims.

Some of the most popular herbal products and supplements include chondroitin sulfate, echinacea, ephedra (also called ma huang), garlic, ginkgo biloba, ginseng, glucosamine, kava, melatonin, phytoestrogens (such as black cohosh, dong quai and soy), saw palmetto and St. John’s wort.

Herbal Products and Supplements: What You Should Know

This information was developed as part of an educational program made possible by an unrestricted educational grant from McNeil Consumer & Specialty Pharmaceuticals.
Are herbal health products and supplements safe because they’re natural?
Not necessarily. Don’t think that herbal health products and supplements are safer than medicines just because they occur in nature or come from plants. After all, many plants are poisonous! Although herbal products and supplements are advertised as “natural,” they aren’t necessarily natural to the human body.

Unlike prescription and over-the-counter (OTC) medicines, herbal products and supplements don’t have to be tested to prove they work well and are safe before they’re sold. Also, they may not be pure. They might contain other ingredients, such as plant pollen, that could make you sick. Sometimes they contain drugs that aren’t listed on the label, such as steroids or estrogens. Some of these products may even contain toxic (poisonous) substances, such as arsenic, mercury, lead and pesticides.

Ways to Help Improve Women's Health

Below are several ways you can help improve women’s health through your clinic, practice, community, or organization. Whether you want to take on one project as an individual or several as a group, there’s something for anyone interested in encouraging women to practice prevention to be healthy and safe.

Breast and Cervical Cancer Screening
CDC provides high-quality screening and diagnostic services to detect breast and cervical cancer at the earliest stages through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The program helps low-income, uninsured, and underinsured women (ages 40-64 years), gain access to breast and cervical cancer screening and diagnostic services.

DES Exposure
Research shows that women exposed to diethylstilbestrol (DES) in utero (DES Daughters) were at increased risk of the development of clear cell adenocarcinoma of the vagina and cervix. CDC's DES Update has been specifically designed to help health care providers learn more about DES exposure and its known health effects to facilitate identifying, managing, and counseling DES-exposed patients.

Gynecologic Cancer Awareness
Help raise awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. When gynecologic cancers are found early, treatment is most effective. Know the central messages of the campaign, and use the fact sheets to increase awareness.

Sun Protection
Exposure to the sun's ultraviolet (UV) rays appears to be the most important environmental factor involved in the development of skin cancer. When used consistently, sun-protective practices can prevent skin cancer. People with certain risk factors are more likely than others to develop skin cancer.
Take Continuing Education Courses

Women's Health Continuing Education for Health Professionals
View a listing of selected CDC continuing education programs related to women’s health and other topics.
Start a Needed Program in Your Community

A Family Lifestyle Approach to Diabetes Prevention (Power to Prevent)
This program is designed to encourage African Americans at increased risk for type 2 diabetes to become more physically active and to eat healthier foods to prevent or delay the disease.

Assuring Healthy Caregivers- A Public Health Approach to Translating Research into Practice: The RE-AIM Framework
Those concerned with caregivers and their family and friends can use this framework in their work on caregiving. It suggests additional resources for those interested in pursuing the use of RE-AIM for caregiver support programs and policies.

Preventing Falls: How to Develop Community-Based Fall Prevention Programs for Older Adults
This “how-to” guide is designed for community-based organizations who are interested in developing their own effective fall prevention programs. This guide is designed to be a practical and useful tool, and it provides guidelines on program planning, development, implementation, and evaluation. See also Preventing Falls: What Works- A CDC Compendium of Effective Community-Based Interventions from around the World.

WISEWOMAN
Well–Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) provides low-income, under- or uninsured 40- to 64-year-old women with the knowledge, skills, and opportunities to improve diet, physical activity, and other lifestyle behaviors to prevent, delay, and control cardiovascular and other chronic diseases. The interventions may vary from program to program, but all are designed to promote lasting, healthy lifestyle changes. See also Wise Interventions.
Use Resources

Women's Health Podcasts
Take one to six minutes to listen to a podcast to learn more about issues impacting women's health and safety, including cancer, reproductive health, sexually transmitted infections, and violence. See also CDC Podcasts.

Women's Health Professional Resources
View a variety of resources for health professionals, including campaigns, continuing education, slidesets, videos, and more.

Assisted Reproductive Technology (ART) Success Rates Report
The goal of this report is to help potential ART users make informed decisions about ART by providing some of the information needed to answer the following questions: What are my chances of having a child by using ART? Where can I go to get this treatment?

Bleeding Disorders in Women
The most common bleeding disorder is von Willebrand disease (VWD). VWD results from a deficiency or defect in the body's ability to make von Willebrand factor, a protein that helps blood clot. Although VWD occurs in men and women equally, women are more likely to notice the symptoms because of heavy or abnormal bleeding during their menstrual periods and after childbirth. Certain women should be tested.

Breastfeeding
Newborn infant Crib Cards can be used by hospitals for recording a newborn’s vital information. It can also help parents be better informed about breastfeeding and help make this important infant feeding decision at the pertinent time.

Intimate Partner Violence and Sexual Violence Victimization Assessment Instruments for Use in Healthcare Settings
This publication includes a comprehensive inventory of assessment tools that will help practitioners identify victims of intimate partner violence and sexual violence victimization in clinical/healthcare settings and make appropriate referrals for additional services.

Prenatal Testing for HIV Infection
The One Test. Two Lives. campaign focuses on ensuring that all women are tested for HIV early in their pregnancy. One Test. Two Lives. provides quick access to a variety of resources for providers and patients to help encourage universal voluntary prenatal testing for HIV.

Sexually Transmitted Disease Treatment Guidelines
Keep up with the latest guidelines on the treatment of sexually transmitted diseases. These guidelines were developed by CDC after consultation with a group of professionals knowledgeable in the field of STDs. The guidelines are updated periodically.

Be a Role Model

Be Physically Active
Participating in moderate-intensity or vigorous-intensity physical activity on a regular basis can lower an individual's risk of developing coronary heart disease, stroke, non-insulin-dependent (type 2) diabetes mellitus, high blood pressure, and colon cancer by 30–50%. Also, active people have lower premature death rates than people who are the least active. CDC recommends a minimum of 30 minutes of moderately intense physical activity most days of the week.

Eat Healthy
Health professionals recognize the benefits associated with a healthful eating plan based on the Dietary Guidelines for Americans, including decreased risk of overweight and obesity; decreased risk of micronutrient deficiencies; and decreased risk of chronic diseases, such as type 2 diabetes, hypertension, and certain cancers.

Be Smoke-Free
People who stop smoking greatly reduce their risk for many chronic diseases and for dying prematurely. Make this the year you quit smoking for good.

Asthma risk from too many nuts in pregnancy

Pregnant women who eat nuts or nut products like peanut butter daily raise the risk their children will develop asthma by 50 percent, Dutch researchers said on Tuesday.

The study also showed that moderate amounts did not seem to have an effect, meaning it is too soon to say whether pregnant women should give up nuts because they contain many important nutrients and healthy fats a developing fetus needs, they said.

"We were the first to find these strong effects on asthma symptoms," said Saskia Willers, an epidemiologist at Utrecht University, who led the study linking nuts with asthma.

But until we are certain we don't want to restrict them from the diet. So it is important that other studies replicate the findings," she said.

Asthma is an inflammatory disease causing wheezing, coughing and labored breathing that can be life threatening. In some countries as many as 30 percent of children develop the condition, according to the World Health Organization.

Scientists do not exactly know why some children develop asthma, although some believe that allergies can trigger the disease that causes a narrowing of the bronchial tubes.

Nuts and seafood are known to contain allergens that cause food allergies but the Dutch team only found a link between peanuts and asthma, Willers said.

In their study, more than 4,000 pregnant women completed a dietary questionnaire that asked whether they consumed vegetables, fresh fruit, fish, eggs, milk, milk products, nuts and nut products rarely, regularly or daily.

The researchers, who published their findings in the American Journal of Respiratory and Critical Care Medicine, then assessed the children's diets and looked to see who had developed asthma over an eight-year period.

Children whose mothers ate as little as one peanut butter sandwich a day had a far higher risk of asthma, Willers said in a telephone interview.

"If you eat moderately, it is probably not a problem," she said. "It is only if you eat nuts or nut products on a daily basis."

The study did not find a mechanism but Willers said peanut allergens may be crossing the placenta and sensitizing a fetus, making a child more prone to the disease.

The researchers also found a small benefit from eating fruit daily, and reported that the link between asthma and nuts remained after factoring for the child's diet, Willers added.

Ladies, give your breasts a rest, research says

Like many women, I’ve felt guilty about my slipshod breast exams for years. Sure, I’ll give the girls a good once-over in the shower now and then, but I’ve never diligently gone through all the motions (circular and otherwise), month in and month out.

So it was with a certain amount of relief that I read a new analysis confirming that the breast self-exam (or BSE) truly doesn’t make much of a difference after all.

According to a review by the Cochrane Collaboration, an international organization that evaluates medical research, there’s no evidence that self-exams actually reduce breast cancer deaths. In fact, the often-recommended monthly chore may even do more harm than good, according to the group’s analysis of a pair of studies of nearly 400,000 Chinese and Russian women.

Data from two large trials do not suggest a beneficial effect of screening by (BSE) but do suggest harm in terms of increased numbers of benign lesions identified and an increased number of biopsies performed,” concluded the authors in Tuesday’s issue of The Cochrane Library. “At present, screening by breast self-examination … cannot be recommended.”

One fewer thing to do?
Chris Herget, a 44-year-old notary public from Bellevue, Wash., says while she’s surprised to hear this news, she, too, feels relieved.

“I’ve never really felt competent doing it myself anyway and I have very fibrous breasts so everything feels like a ‘pea,’” she says. “In fact, the first time I told a doctor that I thought I’d found a lump, he was like, ‘That’s nothing, that’s a fat cell.’”

But the news that the BSE is officially on the way out perplexes others.

“I guess it’s one less thing that I need to be doing, but it is a little confusing,” says Liz Lane, a 29-year-old public relations manager from New York City. “Now I’m not sure what I am supposed to do to check myself.”

The issue is complicated, acknowledges Dr. David B. Thomas, breast cancer epidemiologist at Seattle’s Fred Hutchinson Cancer Research Center and professor of epidemiology at the University of Washington.

“It’s important to separate out the public health implications from the implications for an individual woman,” says Thomas, who is also the author of the 2002 landmark study involving more than 250,000 Chinese women that was analyzed and affirmed by this latest review.

“If a woman is highly motivated — let’s say her mother or sister has been diagnosed with breast cancer — then of course she should practice breast self-exam. But that’s a different situation than trying to reach women on a mass scale. Our study shows that that’s probably a waste of time. You’re not going to get women sufficiently motivated to practice it well enough and frequently enough to make that big of a difference.”

Lumps and bumps can be normal
What’s more, Thomas says BSEs can be problematic because the lumps and bumps women do report often turn out to be benign.

“The price you pay for doing more thorough breast exams is you’re going to find more benign lesions and that will result in unnecessary surgical procedures,” he says.

Rhebe Greenwald, a 65-year-old retired art director and systems analyst from Port Townsend, Wash., has experienced this firsthand.

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“I’ve never felt breast self-exams were that useful for me,” she says. “I’m extremely lumpy and I’ve had three benign tumors removed that were all found through self-exams. The last time, they removed about a quarter of the tissue in my breast and found nothing.”

But others, like Dianne Pomon, a 59-year-old registered nurse and breast cancer survivor from Pottstown, Pa., swear by the BSE.

“I’ve been diagnosed with breast cancer three times and found the lumps myself every time,” she says. “I would strongly encourage women to check themselves every month.”

What's a woman to do?
What’s a woman to do? It all depends on your age and family history, says Thomas.

“Women in their 20s and 30s rarely get breast cancer,” he says. “But they do have a lot more benign lumps and bumps. It’s not worth emphasizing breast self-exams for women at this age.”

As we get older, though, the benign lumps tend to go away and the breast cancer risk goes up.

When women are in their 40s, it’s a good time for them to become more aware of their breasts and more aware of changes that might be due to breast cancer,” he says. “It’s kind of controversial as to whether it’s worth the screening — either BSEs or mammograms — but they can do both if they want.”

After age 50, though, an annual mammogram is a proven lifesaver, he says, reducing the risk of breast cancer death by about 30 percent to 40 percent. And women who know they’re at high risk for breast cancer may be able to enhance the benefit of mammograms with diligent BSEs between screenings.

As for me, while I'm relieved to scratch breast self-exams from my to-do list for good, I’ve got no problem putting my girls into the hands of true professionals. I’m heading for the local breast health care center for my annual mammogram. It’s time.

Menopause raises risk of metabolic syndrome

As women begin to enter menopause, their risk of developing a collection of heart disease risk factors appears to climb, a study has found.

Researchers found that among 949 U.S. women followed for nearly a decade, the risk of developing metabolic syndrome increased during perimenopause — the years during which a woman’s body begins to transition into menopause, usually starting somewhere in her 40s.

Metabolic syndrome refers to this cluster of risk factors for heart disease, stroke and diabetes — including high blood pressure, abdominal obesity, high blood sugar, low levels of ”good” HDL cholesterol and high triglycerides (another type of blood fat). The syndrome is usually diagnosed when a person has three or more of these traits.

The new findings, published in the Archives of Internal Medicine, appear to be the first showing that the incidence of metabolic syndrome begins to rise during perimenopause.

More specifically, the study found, the risk is related to increases in testosterone activity.

The “main message” here for women is that maintaining a healthy lifestyle may be especially critical during perimenopause, lead researcher Dr. Imke Janssen, of Rush University Medical Center in Chicago, told Reuters Health.

Healthy habits can help
Not smoking, eating a healthy diet and getting regular exercise can all help reduce a woman’s risk of the various components of metabolic syndrome, Janssen said.

She and her colleagues based their findings on an ethnically diverse sample of U.S. women who were between the ages of 42 and 52 and free of metabolic syndrome at the outset. The women were followed for nine years.

Overall, Janssen’s team found, nearly 14 percent developed metabolic syndrome by the time they had their final menstrual period. The risk of developing the syndrome increased progressively starting six years before the final menstrual period.

But while the odds of developing metabolic syndrome were elevated after menopause, the risk was greater during perimenopause, Janssen noted.

It has long been known that women generally have a lower risk of cardiovascular disease than men do before the age of 45. But after age 55, the trend reverses, with women actually being at greater risk than men their age.

“Obviously, something happens there, between 45 and 55,” Janssen said, noting that it was once assumed that diminishing levels of estrogen told the whole story.

Testoserone may play greater role
But in this study, women’s estrogen levels were unrelated to the odds of developing the metabolic syndrome. Instead, the syndrome correlated with an increase in testosterone activity — suggesting that the direct negative effects of testosterone are more important than the loss of estrogen’s positive effects in women’s cardiovascular risks.

This idea, Janssen and her colleagues note, is consistent with clinical trials that have found no cardiovascular benefits from estrogen replacement therapy.

The bottom line for women, according to Janssen, is that during these years of hormonal change, healthy habits become more important than ever.

Urban teens misunderstand ‘morning-after pill

Urban-living minority girls appear to lack general knowledge about emergency contraceptive pills — more commonly known as the "morning-after" pill, new research hints.

Morning-after pills, which are taken after intercourse, consist of hormones that prevent a pregnancy from occurring. Since they can be taken immediately after intercourse (instead of waiting until the "morning after"), some doctors prefer the term "emergency contraception."

The emergency contraceptive pill is a safe and effective means of preventing pregnancy for up to 5 days after unprotected intercourse or when other forms of contraception, such as birth control pills or condoms, have not been effective, Dr. Cynthia J. Mollen of Children's Hospital of Philadelphia in Pennsylvania told Reuters Health.

Yet, "multiple misconceptions" about emergency contraceptive pills exist, Mollen said.

Mollen and colleagues assessed the knowledge of, and attitudes toward, emergency contraceptive pills among 30 English-speaking black girls between 15 and 19 years old who sought emergency department care.

Sixteen of the girls said they were sexually active — 5 with a history of pregnancy — and 14 said they were not sexually active, the investigators report in the medical journal Pediatrics.

In hour-long interviews with each girl, the researchers learned that 94 percent of the sexually active girls had at least heard of the morning-after pill, Mollen said. However, 40 percent of these young women were unable to answer follow-up questions on how the pills work.

Among girls who were not sexually active, 50 percent had never heard of the morning-after pill, and just 4 girls who had heard of this form of contraception knew when to use it or how to obtain it.

Mollen's group found only 7 girls (5 sexually active and 2 not sexually active) who knew of the Food and Drug Administration approval of non-prescription Plan B — a brand name emergency contraception pill for women age 18 and older.

Many of the adolescents said emergency contraceptive pill users should feel embarrassed and thought healthcare providers would likely call users' parents or caregivers. The girls' also expressed concerns about side effects, including those not known to occur with the morning-after pill, Mollen said.By identifying specific barriers to the use of emergency contraception in this population, Mollen notes, "we provide a framework for future interventions aimed at increasing emergency contraception pill use.

More women are having fewer children, if at all

More women in their early 40s are childless, and those who are having children are having fewer than ever before, according to the U.S. Census Bureau.

In the last 30 years, the number of women age 40 to 44 with no children has doubled, from 10 percent to 20 percent. And those who are mothers have an average of 1.9 children each, more than one child fewer than women of the same age in 1976.
The report, Fertility of American Women: 2006, is the first from the Census Bureau to use data from an annual survey of 76 million women, ages 15 to 50, allowing a state-by-state comparison of fertility patterns. About 4.2 million women participating in the survey, which was conducted from January through December 2006, had had a child in the previous year. The statistics could be used by state agencies to provide maternal care services, the report said
The survey found that in 2006 women with graduate or professional degrees recorded the most births of all educational levels. About 36 percent of women who gave birth in the previous 12 months were separated, divorced, widowed or unmarried.

Unemployed women had about twice as many babies as working women, although women in the labor force accounted for the majority — 57 percent — of recent births. Only a quarter of all women who had a child over the past year were living below the poverty level.

Coupled with fertility data collected biannually, the report also revealed longer term trends, including how second-generation Hispanic women are having fewer babies than their foreign-born grandmothers and first-generation American mothers.

Differences among states also emerged. California, Nevada, Texas, Arizona, Florida, Illinois, New York and New Jersey had a greater percentage of foreign-born women who became mothers in 2006. A bigger share of women in the Southeast and Southwest who gave birth in the year prior to the survey did so in poverty.

Surrogate mom, 61, gives birth to own grandkid

A 61-year-old Japanese woman gave birth to her own grandchild, using an egg donated by her daughter, a clinic said Thursday.

Surrogate births are extremely rare in Japan and banned by industry groups, but they are not illegal. The Suwa Maternity Clinic in Nagano, northwest of Tokyo, refused to provide information such as the date of the birth or gender of the baby. News reports said the baby was born last year.

The clinic said it performed the procedure because the woman's daughter has no uterus, but didn't give details on why she had that condition. The surrogate mother used a fertilized egg donated by her daughter.

Both surrogate mother and baby were fine," said Chihiro Netsu, a spokeswoman for the clinic.

Dr. Yahiro Netsu, who runs the clinic, has long defied national opposition to such procedures, arguing that they should be an option for women who are infertile.

Japan's oldest new mother?
In 2001, he performed what is thought to be the country's first successful surrogate birth. In 1998, Netsu was expelled from Japan's gynecology association for performing in-vitro fertilizations with eggs and sperm of donors who were not married to each other, though he was later reinstated.

Mainichi newspaper reported that the previous oldest mothers in Japan were two 60-year-old women implanted with their own fertilized eggs in the United States.

Japan Society of Obstetrics and Gynecology, a powerful body with over 15,000 members, has banned such procedures, but they are not illegal and individual clinics are free to perform them — though few actually do.

At Suwa Maternity Clinic, eight surrogate mothers have given birth. Of them, four women have delivered babies using fertilized eggs from their daughters.

The clinic will report the latest case at a conference of the Japan Society of Fertilization and Implantation later this month. It was the first time the fertilization conference had taken up the subject of surrogate births, Netsu said.

Yoga soothes worst symptoms of menopause

Yoga can reduce hot flashes and night sweats among women going through menopause, and also appears to sharpen their mental function, researchers from India report.

To investigate whether yoga would help women with physical and cognitive symptoms of menopause, they randomly assigned 120 menopausal women, 40 to 55 years old, to yoga practice or simple stretching and strengthening exercises five days a week for eight weeks.

The postures, breathing and meditation included in the yoga intervention were "aimed at one common effect, i.e. 'to develop mastery over modifications of the mind' ... through 'slowing down the rate of flow of thoughts in the mind,"' the researchers explain.

Women in the yoga group also listened to lectures on using yoga to manage stress and other yoga-related topics, while those in the control group heard lectures on diet, exercise, the physiology of menopause, and stress.

Fewer hot flashes, better concentration
After eight weeks, women in the yoga group showed a significant reduction in hot flashes, night sweats, and sleep disturbances, while the women in the control group did not, Dr. R. Chattha, of the Swami Vivekananda Yoga Anusandhana Samsthana in Bangalore, India, and colleagues found.

Both groups showed improvements in a test of attention and concentration, although improvement in the yoga group was significantly greater. In a test of memory and intelligence with 10 components, the yoga group improved on eight, while the control group improved on six. Improvements were significantly greater in the yoga group than in the control group on seven of the subtests.

"The present study shows the superiority of yoga over physical activity in improving the cognitive functions that could be attributed to emphasis on correctness in breathing, synchronizing breathing with body movements, relaxation and mindful rest," the researchers suggest.

Tips for a Healthy Life for Women

Eat Healthy
"An apple a day keeps the doctor away." There's more truth to this saying than we once thought. What you eat and drink and what you don’t eat and drink can definitely make a difference to your health. Eating five or more servings of fruits and vegetables a day and less saturated fat can help improve your health and may reduce the risk of cancer and other chronic diseases. Have a balanced diet, and watch how much you eat.

Keep a Healthy Weight
Obesity is at an all time high in the United States, and the epidemic may be getting worse. Those who are overweight or obese have increased risks for diseases and conditions such as diabetes, high blood pressure, heart disease, and stroke. Eat better, get regular exercise, and see your health care provider about any health concerns to make sure you are on the right track to staying healthy.

Be Active
More than 50 percent of American men and women do not get enough physical activity to provide health benefits. For adults, thirty minutes of moderate physical activity on most, preferably all, days of the week is recommended. It doesn’t take a lot of time or money, but it does take commitment. Start slowly, work up to a satisfactory level, and don’t overdo it. You can develop one routine, or you can do something different every day. Find fun ways to stay in shape and feel good, such as dancing, gardening, cutting the grass, swimming, walking, or jogging.

Be Smoke-Free
Health concerns associated with smoking include cancer, lung disease, early menopause, infertility, and pregnancy complications. Smoking triples the risk of dying from heart disease among those who are middle-aged. Second-hand smoke - smoke that you inhale when others smoke - also affects your health. If you smoke, quit today! Helplines, counseling, medications, and other forms of support are available to help you quit.

Get Check-Ups
Sometimes they’re once a year. Other times they’re more or less often. Based on your age, health history, lifestyle, and other important issues, you and your health care provider can determine how often you need to be examined and screened for certain diseases and conditions. These include high blood pressure, high cholesterol, diabetes, sexually transmitted diseases, and cancers of the skin, cervix, breast, and colon. When problems are found early, your chances for treatment and cure are better. Routine exams and screenings can help save lives.

Get Vaccinated
They’re not just for kids. Adults need them too. Some vaccinations are for everyone. Others are recommended if you work in certain jobs, have certain lifestyles, travel to certain places, or have certain health conditions. Protect yourself from illness and disease by keeping up with your vaccinations.

Manage Stress
Perhaps now more than ever before, job stress poses a threat to the health of workers and, in turn, to the health of organizations. Balancing obligations to your employer and your family can be challenging. What’s your stress level today? Protect your mental and physical health by engaging in activities that help you manage your stress at work and at home.

Know Yourself and Your Risks
Your parents and ancestors help determine some of who you are. Your habits, work and home environments, and lifestyle also help to define your health and your risks. You may be at an increased risk for certain diseases or conditions because of what you do, where you work, and how you play. Being healthy means doing some homework, knowing yourself, and knowing what’s best for you... because you are one of a kind.

Be Safe - Protect Yourself
What comes to mind when you think about safety and protecting yourself? Is it fastening seat belts, applying sunscreen, wearing helmets, or having smoke detectors? It’s all of these and more. It’s everything from washing your hands to watching your relationships. Did you know that women at work die most frequently from homicides, motor vehicle incidents, falls, and machine-related injuries? Take steps to protect yourself and others wherever you are.

Be Good to Yourself
Health is not merely the absence of disease; it’s a lifestyle. Whether it’s getting enough sleep, relaxing after a stressful day, or enjoying a hobby, it’s important to take time to be good to yourself. Take steps to balance work, home, and play. Pay attention to your health, and make healthy living a part of your life.