Women's Health in Chatelaine Magazine

A SPONSORED FEATURE FROM MEDIAPLANET
WOMEN’S HEALTHPERSONALHEALTHNEWS.CA
S
tatistically, thyroid cancer
affects more women than
men. In 2017, according to
the Canadian Cancer So-
ciety, approximately 5,400
women will be diagnosed
with the disease.
But, as celeb Brooke Burke-Charvet
points out,cancer can be overcome and the
bestwaytodosoistocatchitearly.
Burke-Charvetwas diagnosedwith thy-
roid cancer in 2012 and it was a complete
surprise.“Mycancerwas caught in a regu-
lar, general physical checkup. I had no
symptoms at all,which is quite common,
and I was fortunate to have a very thor-
ough doctor who felt a lump and recom-
mended I check it out and have an ultra-
sound,” says Burke-Charvet.
Otherthanalump,symptomsofthyroid
cancer may include a cough, neck swell-
ing,difficultyswallowing,andhoarseness,
but it tends to be a slower-growing cancer
and patients often don’t knowtheyhave it
untilathyroidectomy—apartialorfullre-
moval of the thyroid gland — is done.
Burke-Charvet had several ultrasounds,
in fact, before it was recommended she
have a thyroidectomy, and it was con-
firmed that she had thyroid cancer.
“Hearing the c-word is scary,” says
Burke-Charvet.“I’ve always been commit-
tedtohealthandwellness,andthisshowed
me that I was not invincible.It was shock-
ing and it was scary,because I think most
peoplerelatethewordcancertodeath.”
Dealing with cancer
Burke-Charvetdidtwothingswhenshewas
diagnosed: she researched her condition,
andsheassembledtherightteam.“Ididalot
of research so that I could fully understand
the diagnosis,” she says. “When I began to
understandwhat Iwas going to go through,
it helped me remain positive.I also immedi-
atelydecidedtogatherateamofdoctorswith
whomIcouldhaveapartnership.Igotsever-
al opinions,which I think isveryimportant,
and then I decided to be a good patient and
toputfaithinmyteamandstaypositive,be-
causealotofnegativitycanbrewinfear.”
Her team extended beyond the medical
field,though,and Burke-Charvet stresses
the importance of having people around
youwho can provide support:
“These are the people you can count on
in your life — your friends, your family,
yourdoctors.Findingthosepeoplewhocan
guideyouandtakecareofyouisinvaluable.
My best girlfriend also had thyroid cancer
and she was a powerful force for me,com-
forting me and guiding me with her ex-
perience.This was one of the reasons why
I decided to make a public announcement
about my diagnosis.I wanted to be able to
do that same thing for other people who
weregoingthroughthyroidcancer.”
Taking preventative measures
Today, things are good. “Now, life goes
on as usual for me and I feel great,” says
Burke-Charvet.“I was horrified to check
into the hospital as a cancer patient,but
I survived it and now I’m able to share
that story and,hopefully,that will help a
lot of people.”
Burke-Charvet was struck to learn how
many people have never had a physical.
“I’m a big believer and advocate for health
and wellness and taking care of yourself.
Wedon’tmissthosetypesofappointments
for our children,so why do we miss them
for ourselves? It’s no joke; take two hours
out of your day and take care of your body.
Earlydetectionsaveslives.”
Her final words of advice? “Don’t be
ruled by fear. Empower yourself with
knowledge, envision positive things,
find a support group, whether in person
or an online community of people going
through something similar, and treat
yourself with compassion.”
Janice Tober
How to Stay Strong
When Cancer
Strikes
“Don’t be ruled
by fear. Empower
yourself with
knowledge,
envision positive
things, find a
support group...
and treat yourself
with compassion.”
— This section was created by Mediaplanet and did not involve Chatelaine Magazine or its editorial department —
Publisher: Tess Sharma Business Developer: Samantha Blandford Country Manager: Jacob Weingarten Production Director: Carlo Ammendolia Lead Designer: Matthew Senra
Web Editor: Camille Co Cover Photo: Overflow Studio, Inc. Photo credits: All images are from Getty Images unless otherwise credited. Inquiries to ca.editorial@mediaplanet.com.
Made possible with the support of AbbVie Inc, Allergan Inc, Anova Fertility Reproductive Health, AstraZeneca Canada, BioSyent Inc, Genesis Fertility Centre, HelloFresh, Hologic Inc, Merck Co,
OvaScience, Procrea Fertility, Radiation Safety Institute of Canada. The opinions in this material are those of the authors and do not necessarily reflect the views of the aforementioned parties.

HUMAN PAPILLOMAVIRUS (HPV) IS THE MOST COMMON SEXUALLY TRANSMITTED
infection globally, with more than 80 percent of sexually active adults being exposed to
it in their lifetime. Chronic HPV infection is directly implicated in the development of
multiple cancers in both men and women. And we have the tools today to defeat it.
A pivotal moment
“We’reatarealturningpointinCanadarightnowwithregardstoHPVawarenessandprevention,”
says Dr.Jennifer Blake,CEO of the Societyof Obstetricians and Gynaecologists of Canada.“We’ve
madeitpastthetime,asexistswithanynewinnovation,wherepeopleareskepticalofwhetherit
willwork.WenowknowdefinitivelythatwecanpreventcancerwiththeHPVvaccine.”
HPV directly causes anal cancer and oropharyngeal (throat) cancer in both men and
women, penile cancer in men, and is the primary cause of cervical cancer, which kills one
Canadian woman every day. In each of these cases, prevention is better than treatment.
“We shouldn’t be in a cancer control frame of mind,” says Dr. Blake. “We should be in a
cancer prevention frame of mind. We need, as a country, to begin to imagine that we could
potentially eradicate cervical cancer by treating it as an infectious disease.”
Education is the key
Despite vaccination programs across the country, too many Canadians remain
unvaccinated and uninformed about the basic realities of HPV. “A lot of people don’t really
know the mechanisms of HPV and cervical cancer, or what the purpose of Pap tests and
vaccination are,” says writer, YouTuber, and former Sexual Health Program Coordinator
for the Government of Nunavut, Anubha Momin. “But it’s really very simple to explain.
Canada’s first observance of its new HPV Prevention
Week, from October 1-7, established the country as a
leader among other nations in its commitment to solving,
once and for all, this major public health issue.
You get the Pap test to detect pre-cancer,
and you get the vaccination to prevent
cancer. If people understood that, and if
they knew that HPV is incredibly common,
I’m sure they would feel a lot more strongly
about getting the vaccination.”
Building on that understanding is the
necessary first step to any real change.
“The public needs to be on board if this
change is going to happen,” says Dr. Blake.
“If Canadians stand up and say, ‘Yes, this
is what we want for ourselves, for our
daughters, for our sons’ — we could do it.”
That’s why HPV Prevention Week is
such a win. Not because HPV issues will
be solved in one week, but because it lays
the groundwork for what needs to happen
in the next fifty-one. “An awareness week
focuses our attention and reminds all of
us, physicians and patients alike, to not
be complacent the rest of the year,” says
Dr. Vivien Brown, Past President of the
Federation of Medical Women of Canada,
which played a major role in spearheading
the initiative.
“HPV-related cancers can be prevented,”
continues Dr. Brown. “But only if we take
the appropriate steps.”
D.F. McCourt
PREVENT HPV,
PREVENT CANCER
Anubha Momin was a long-time sexual health educator before making
the switch to writing and television work. She continues to promote
healthy living via her blog and YouTube channel. Photo | Max Rosenstein
“HPV can go the
way of polio — if
we see an increase
in education and
vaccination.”
PERSONALHEALTHNEWS.CA A SPONSORED FEATURE FROM MEDIAPLANET
Why is HPV prevention
important to you?
Share your story using
#HPVPW17
#CANADAvsHPV

UTERINE FIBROIDS
Uterine fibroids are typically benign growths that develop in the wall of the uterus. Women can
develop a single fibroid or multiple fibroids within the uterus, and they can grow to a variety of sizes.
Fibroid
Fibroid
Fibroid
Fibroid
Fallopian
tube
Ovary
Vagina
Cervix
Uterus
UTERUS WITH FI B RO I DS
70% of women
have uterine fibroids
by age 50.
20-50%
are symptomatic.
ABNORMAL UTERINE BLEEDING
IS THE MOST COMMON SYMPTOM OF
UTERINE FIBROIDS.
Uterine fibroids can cause heavy, painful or prolonged periods,
or spotting between periods.
REFERENCES: 1. www.womenshealth.gov/publications/our-publications/fact-sheet/uterine-fibroids.html 2. www.medicinenet.com/uterine_fibroids/page3.htm 3. Vilos GA et al. SOGC
Clinical Practice Guidelines: The Management of Uterine Leiomyomas: Introduction and Medical Management. J Obstet Gynaecol Can 2015;37(2):157-178.
TALK TO YOUR DOCTOR ABOUT TREATMENT OPTIONS

Fertility Preservation for
THE EMPOWERED WOMAN
A woman’s biological clock doesn’t
have to dictate when she starts a family.
Dr. Marjorie Dixon speaks about the
options available for women who want
to be in control of their family building.
Mediaplanet What is fertility
preservation?
Dr. Marjorie Dixon Fertility
preservation is a process in which
an individual would save or protect
eggs,sperm,or reproductive tissue
for future reproductive use. Trad-
itionally, such methods were used
for those who experienced an ill-
ness that negatively affected their
reproductive health: ie, cancer.To-
day,women are using fertility pres-
ervation,and specifically egg freez-
ing,toopenandstrengthentheirfu-
turefamily-buildingopportunities.
MP The quality and quantity
of a woman’s egg supply
begins to decline significantly
after age 30. What fertility-
preserving options are
available?
MD Unfortunately, women’s fer-
tility health has not caught up
with the social needs of today. By
the time a woman is 30, her ovar-
ies have been depleted of 90 per-
cent of their eggs.Fortunately,the
remaining 10 percent of eggs are
relativelywell-functioning.By the
time she is 40, she will have de-
pleted 97 percent of her eggs,with
the remaining 3 percent being of
relatively poor quality.
MP What is egg freezing?
MDTokeepthingssimpleforevery-
one to understand,eggs are the lar-
gest cells of the human body.A fer-
tility specialist provides a woman
interested in fertility preservation
with medication to produce many
eggs over a number of days. When
the follicles containing the eggs are
of an acceptable size,the doctor re-
trievestheeggsandanembryologist
freezes them for future use.Luckily,
wenowhavetechnologythatallows
us to freeze eggs for almost forever,
withnexttonobadeffects.
MP Who can benefit from
egg freezing?
MD There isn’t a “one size fits all”
when it comes to fertility preserva-
tion for women.Women are all gen-
etically different and have had dif-
ferentenvironmentalexposures.
However, generally speaking,
the earlier a woman freezes her
eggs, the better her egg quality.
Today, we see most women freez-
ing their eggs between the ages of
35 and 38 years,but a woman may
freeze her eggs anytime before the
age of 41. Egg freezing is a fertil-
ity-preservation opportunity that
most women can benefit from. It
empowers women to be in control
of their future familybuilding and
make it precisely what they want
it to look like.
MP How can the option
of fertility preservation
empower women?
MD Egg freezing empowers
women to be the writers of their
own life stories,by relieving them
from the pressures of time. When
the worry of the eggs’ expiry date
is taken off the table, it allows a
woman to focus on her education,
career,travelling,and perhaps tak-
ing the necessary time when look-
ing for the right partner,if desired.
MP When should I talk to
my doctor about fertility
preservation?
MD All women should be aware of
their biological clock. I would rec-
ommend that all women have a
fertility checkup between the ages
of 25 and 30.There are factors that
their family doctor can ask them
about or see on their health hist-
ory, as well as simple blood tests
that can be ordered which could
alert to potential fertility issues.
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A
lthough it’s not as easyto talk about
as hot flashes or night sweats,
vaginal dryness is a very common
issue faced bywomen during meno-
pause and can put an unnecessary damper on a
woman’s self-esteem and a couple’s intimacy.
Estrogen is the culprit.Lowlevels of this im-
portant hormone in menopausal women re-
sult in fewer cell layers lining the vagina.That
means they produce less lubrication and make
the vagina less pliable, causing discomfort,
irritation,and pain during sex.
An international study of menopausal
women, Vaginal Health: Insights, Views and At-
titudes, found that 82 percent of respondents
have experienced vaginal discomfort,particu-
larly during sexual intimacy. But almost 40
percent of those with symptoms did not dis-
cuss this matter with their doctor.There is a
gap in women’s knowledge of their sexual
health,making them less likely to seek treat-
ment for their vaginal dryness. This is un-
fortunate because effective treatments op-
tions are available,and you should speak with
your health care provider.
Judy Leblanc,a 46-year-old wife and mother
basedinSaint-Célestin,QCsufferedwithvagin-
al dryness discomfort for 15 years.Undergoing
radiation to treat cervical cancer triggered her
to go into menopause at age 30.“It made intim-
acy difficult,” she says.“It caused bleeding and
pain.I just accepted the fact I was never going
to have a normal sex life again.”
Her visit to a new doctor changed every-
thing.“He told me there was a new product on
the market that maywork for my needs and to
speak with my pharmacist,as it’s kept behind
the pharmacy counter.”
Her doctor recommended RepaGyn®,a prod-
uct that not only combats vaginal dryness but
helps heal and repair damaged tissues. It is
formulated with hyaluronic acid, a highly ef-
fective lubricating ingredient. Its molecules
can hold more than 1,000 times their weight
inwater.Leblanc used it for a month before be-
ginning to have sex again.
“It really does work!” she says.“It made me
feel normal for the first time since my cancer
treatment. I had tried so many things in the
past — some very expensive, some lubricants
that felt sticky,gooey,and didn’t last.Nothing
was effective for me. My husband and I were
happy that we found a good solution.We were
like a young couple again!”
Michele Sponagle
When Your Sex Life Is menoPaused
When pregnant women think of
prenatal testing, they may envision an
invasive procedure that carries a risk
to both mother and baby.
However, new advances in women’s health
technology mean prenatal screening has ad-
vanced rapidly, especially when it comes to
non-invasive prenatal tests (NIPT),which can
determine abnormalities in fetal DNA by ana-
lyzing a blood sample drawn from the mother.
If thetestcomesbacklow-risk,womennolong-
erhavetorisktheinvasiveamniocentesis,which
requires extracting amniotic fluid in the sac sur-
rounding the fetus and can cause miscarriage in
anestimated0.5to1percentofpregnancies.
“When amniocentesis was the first line
of detection, the risk caused some women to
opt out of screening,” says France Lagacé,the
Diagnostic Laboratory Manager at Procrea
Fertility’s Montreal location.
As the average age of motherhood continues
to climb,so does the risk of genetic conditions.
This risk spikes after age 35, though non-in-
vasive prenatal tests are available to pregnant
women of any age. With less invasive tests,
more families can learn about the health of
their baby, and sooner. A doctor, midwife, or
health care provider can provide the referral.
“The testing allows a couple to have coun-
selling, to make decisions, and to prepare
themselves mentally, physically, and emo-
tionally,” says Melissa Gentile, a Practice Li-
aison at Procrea Fertility.
Fetal DNA tests have been available for a
decade, though a test known as NIFTY — or
non-invasive fetal trisomy— is the onlyone in
Canada that tests all 23 pairs of chromosomes
with such accuracy.
NIFTY measures the risk for trisomies 21,18,
and13withover99percentaccuracy.Womencan
visitalabsuchasProcreaoroneofitscross-Can-
ada affiliates, provide a blood sample, and wait
forresultsavailableinaround10businessdays.
Since February 2013, the Society of Obstetri-
cians and Gynaecologists (SOGC) recommends
that all high-risk women be offered fetal DNA
testingpriortoamniocentesis.TheSOGCreleased
new guidelines in September recommending
all pregnant women be offered a first-trimester
ultrasound and prenatal screening test for com-
monchromosomalabnormalities.
Non-InvasivePrenatalTestingisNIFTY
SPONSORED
France Lagacé
Diagnostic Laboratory
Manager, Procrea Fertility,
Montreal
In addition to NIFTY,Procrea’s labs also con-
duct other diagnostic tests familiar to many
women, including SENTIS,which detects the
BRCA-1 and BRCA-2 gene mutation frequent-
ly associated with the predisposition of breast
and ovarian cancers.
Zoe Davey
Melissa Gentile
Practice Liaison,
Procrea Fertility
To learn more about these tests and
other services, visit procrea.ca

Mediaplant Some women
are afraid to work out while
pregnant. What advice can you
give these women?
Tammy Hembrow If you have any
concerns,like any exercise routine,my
first advice is to speak with your doc-
tor.As long as they have given you the
all clear,I believe it is the healthiest op-
tion to stay active while pregnant.Per-
sonally, I paid extra attention to stay-
ing hydrated and really listened to my
body by taking breaks when I felt I
needed to.While pregnant and in prep-
aration for giving birth,your joints are
loosened by the hormone relaxin, so I
would also advise to not put too much
additional stress on your joints and
focus on engaging your core.Still chal-
lenge yourself, but don’t push yourself
too hard — your body is already doing
something incredible.
MP How did your diet change
when you were pregnant but
still lifting?
TH Mydiet didn’t reallychangewhile I
was pregnant — I just ate more! It was
very similar to what I eat now, which
is a high-protein diet with complex
carbs, lots of dark leafy greens, and a
few cheat days.However,the main dif-
ference is that I didn’t restrict my cal-
ories while pregnant.
MP How do you balance fitness
and motherhood? What advice
can you give new mothers in
this regard?
TH I’m lucky I have a great family sup-
port system,because I’m such a hands-
on Mom. Reece and I work as a team
parenting and supporting one an-
other’s goals — I’m really grateful for
that. Having said that, with a new ba-
by or babies, it does take some time to
figure out your routine.There is no set
formula to balancing: you need to find
out what works for you, your family’s
schedule, and your lifestyle. For the
days I can’t get to the gym, I still like
to get my workout in when the babies
nap. Now I have a pretty good balance.
Reece and I alternatewatching the kids
when the other wants to work out at
the gym, and we work this around our
work schedules as well.
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For Dinner?
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Photo | Submitted

If you have been diagnosed with Poor Ovarian Response (POR)
or Primary Ovarian Insufficiency (POI), you may qualify for the
OvaPrime clinical research study.
You may be eligible to participate in a study
Struggling with Fertility?
Up to 1 in 4 women undergoing in vitro fertilization (IVF)
fail to recruit sufficient number of high quality eggs in
response to controlled ovarian hyperstimulation.1
To determine if you are eligible to participate in the study, either:
Visit: www.clinicaltrials.gov and search in “Other Terms” for OvaPrime
Email: ovaprimestudy@triofertility.com
Call: (888) 328-6924
1in4womenhaveinsufficient
numberofhighqualityeggs
Women undergoing IVF
Sufficient
Insufficient
1
KearySDetal,1997 OvaPrimeisaservicemarkofOvaScience,Inc.Allrightsreserved.

GARDASIL9.ca
®
Merck Sharp Dohme Corp. Used under license.
© 2017 Merck Canada Inc.All rights reserved. VACC-1154301-0004
In girls and women ages 9 to 45, GARDASIL®
9 helps protect against cervical, vaginal, and vulvar cancers caused by HPV types 16, 18, 31, 33, 45, 52 and 58, abnormal and precancerous
cervical lesions as found in a Pap test caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, and genital warts caused by HPV types 6 and 11. In girls, women, boys and men ages 9 to
26, GARDASIL®
9 helps protect against anal cancer caused by HPV types 16, 18, 31, 33, 45, 52, and 58, and abnormal and precancerous anal lesions caused by HPV types 6, 11, 16, 18, 31,
33, 45, 52, and 58. It also helps protect boys and men ages 9-26 against genital warts caused by HPV types 6 and 11. GARDASIL®
9 does not treat HPV infection. GARDASIL®
9 may not fully
protect each person who gets it. GARDASIL®
9 does not remove the need for cervical cancer screening; women should still get routine cervical cancer screening. GARDASIL®
9 is not recommended
for use in pregnant women. As with other vaccines, GARDASIL®
9 may cause some side effects and allergic reactions. The most common side effects seen are pain, swelling, redness, itching,
bruising, bleeding, a lump where the shot is given, headache, fever, nausea, dizziness, tiredness, diarrhea, abdominal pain and sore throat. Contact your doctor or healthcare professional to
see if GARDASIL®
9 is right for you.
HPV=human papillomavirus
Information about GARDASIL®
9 is provided in the Product Monograph and Consumer Information available at www.merck.ca.
Ask your healthcare professional about GARDASIL
®
9 today.
HPV causes almost all
cases of cervical cancer.
You can help
PREVENT
CERVICAL
CANCER
with a vaccine.

L
ung cancer claims nearly twice as
many Canadian women’s lives as
breast cancer,according to 2017 Can-
adian Cancer Society data.This rep-
resents 10,000 women’s lives lost per year due
to lung cancer. While there is no doubt that
smoking dramatically increases your risk of
developing lung cancer, it’s not the whole
story. Health Canada has stated that 1,600 of
these cancer deaths can be attributed to ex-
posure to radon gas in homes. So it’s critic-
al that we all consider opportunities to mini-
mize our,and our family’s,risk.
Radon gas occurs naturally in the environ-
ment and can sometimes accumulate to high
levels in residential homes,creating a hazard
that can affect your and your family’s health.
There’s good news, though: while you can’t
see,smell,or taste radon gas,there are simple
tests that can detect its hazardous levels,thus
helping you take the first step in preventing
radon-induced cancer.
Test your home radon levels
Health Canada says all homes have
some level of radon, and their esti-
mates suggest that about seven per-
cent have high levels above the safe
guidelines. Not everyone exposed
to radon will develop cancer,but is
it worth the risk when
a simple test can help
your peace of mind?
There are simple
stepsyou can take to pro-
tect your family. Start by
testing your home’s radon
levels with an inexpensive
home testing kit, available for
order online and at major retail-
ers.Ifyour home has high levels,don’t despair.
Hiring a certified radon mitigation profes-
sional can helpyou find the bestwayto reduce
the radon levels in your home.Health Canada
says that radon levels in most homes can be
reduced by 80 percent or more,reducing your
cancer risk and making your home healthier
for you and your family.
Rob Csernyik
Preventing Cancer with a Simple Test
(1)Knowledge is power
These days we track our diets, fitness, and
sleep cycles. I believe we deserve to be equally
informed about our fertility. See your family
doctor or a local fertility specialist to assess
your ovarian reserve through blood tests such
as anti-mullerian hormone (AMH) and an an-
tral follicle count (AFC) ultrasound. Fertility
is a “functional” diagnosis, so until you try,
you don’t know if you will have difficulty —
regardless of whether the numbers are high
or low. However, earlier knowledge about
low numbers may be useful information for
family planning.
(2)Don’t wait!
Whatever “ready” means for you,getting preg-
nant will be easier when a woman is young-
er. If you know you might have trouble — for
example: endometriosis, polycystic ovaries, a
history of tubal disease, or sexually transmit-
ted infection — seek help sooner.It is true that
40 percent of fertility involves male factors,
but the reasons are different.
(3)Be proactive: the “fertility gender
gap” is real
For women, our eggs are our age — and our
fertility declines with age. Men produce new
sperm, so their sperm is only two months old.
These days,egg freezing can help to prolong fer-
tility until you are ready.But be aware that egg
freezingisnotaguarantee.Successratesvaryby
age,clinic,and situation.
(4)Don’t stress
When you are trying to conceive naturally, the
best advice I give to my patients is to try natural-
ly.Put away the ovulation sticks,basal body tem-
perature charts,and mucus testing.Ifyour cycles
are regular,you are ovulating.The egg lives for 12-
24 hours and the sperm live for three days.There-
fore,regular intercourse every two or three days
without the use of sperm-killing lubricants gives
thebestchances.Ifyourcyclesareirregularoryou
havenosuccessafter6-12months,seekhelp.
What Women Need to Know
About Fertility
Talk to your fertility specialist or visit
genesis-fertility.com/egg-freezing
to learn more.
SPONSORED
Dr. Sonya Kashyap, MD, MSc,
MSc Epi, FRCSC, FACOG, is
the Medical Director and an
IVF and egg-freezing specialist
at Genesis Fertility Centre, and
Assistant Professor of the Division
of Reproductive Endocrinology
and Infertility at the Department
of Obstetrics and Gynaecology
at the University of British
Columbia. Dr Kashyap is the recipient of many national
and international awards, including the Canadian Institutes
of Heath Research New Investigator Award in Gender
Health (2007-12), returning to Canada after a prestigious
fellowship at Cornell University Medical College, and
a faculty position at the University of California at San
Francisco, National Institutes of Health and Center of
Excellence for Women's Reproductive Health.
SPONSORED
“Not everyone exposed to radon
will develop cancer, but isit
worththeriskwhenasimpletest
can help your peace of mind?”
To read more on the fertility gender gap,
go to huffingtonpost.ca/dr-sonya-
kashyap-md-msc-epi-frcsc-facog/
fertility-gender-gap_b_16627398.html

• Trichomonas vaginalis (TV) is more prevalent than chlamydia and gonorrhea.1
• Left untreated TV can be linked to prolonged HPV infection, concurrent STI’s,
increased risk of HIV transmission, preterm delivery, anxiety and discomfort.2
• Current testing methods can miss up to 50% of infections. 3
• The Hologic Aptima Trichomonas vaginalis assay detects up to 100%
of TV infections. 3
Finding and treating the
most common, curable STI
isn’t trichy anymore.
1 CDC. Incidence, Prevalence and Cost of Sexually Transmitted Infections in the United States. http://www.cdc.gov/std/stats/sti-estimates-
fact-sheet-feb-2013.pdf. Published February 2013. Accessed May 18, 2015 2 Chapin K, et al. APTIMA® Trichomonas vaginalis, a transcrip-
tion-mediated amplification assay for detection of Trichomonas vaginalis in urogenital specimens. Expert Rev Mol Diagn. 2011;11(7):
679-688 3 Nye M, et al. Comparison of APTIMA Trichomonas vaginalis transcription-mediated amplifi cation to wet mount microscopy,
culture, and polymerase chain reaction for diagnosis of trichomoniasis in men and women. Am J Obstet Gynecol. 2009;200(2):188.e1-7
ADS-00263-CAN-EN Rev.001 © 2015 Hologic, Inc. Hologic, Science of Sure, Aptima, ThinPrep and associated logos are trademarks and/
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The most recent Canadian statistics
about sexually transmitted infections
(STIs) paint a grim picture.
Chlamydia rates have climbed steadily since
the late 90s.The situation is equally serious for
other STIs,such as gonorrhea and trichomonia-
sis. Data from the federal government shows
that young women are the most severely affect-
ed, with an infection rate seven times greater
than the overall national rate.
This alarming trend can be traced to a couple
of important factors. First, guidelines around
Pap smears have changed in recent years. It
used to be recommended that women get them
every year. Now, it’s every three years and the
recommended starting age has gone from 19
to 21.“The increase in STI rates are unintended
consequences of these changes,” says Dr. Anu
Rebbapragada,the Scientific Director of Micro-
biologyat Dynacare.“As a resultwomen are get-
ting tested later and meeting their physician
less frequently.”
STIs on the Rise and Why Testing Matters
A shift in attitudes is also to blame. Young
women have become blasé about STIs, believ-
ing that they’re easily cured with antibiotics.
“That’s not always the case,” says Dr.Rebbaprag-
ada.While drug therapies are often effective,pa-
tientsmaycomeupagainstSTIslikedrug-resist-
ant gonorrhea,which requires longer treatment.
Women can also face fertility issues and cer-
vical cancer caused bythe HPVvirus.
Putting an end to soaring STI rates is
possible through regular testing.The
good news is that tests
have never been more
accurate and conven-
ient. As Dr. Rebbap-
ragada points out, a
single urine sample
can be used for mul-
tiple tests designed
to screen for three
majorSTIs:chlamydia,
gonorrhea, and trichomonas. In
the future,patients may be able to
collect their own samples and just
drop them off for testing.In addition,
more accurate STI tests maybe available
for self-collected vaginal samples.
“There’s really no excuse to have blinders on
ortobelivinginthedark,”saysDr.Rebbapragada.
So get the information you need to protect your
sexual health.Seeyour doctor and get tested.
Michele Sponagle
“Putting an end to soaring STI
ratesispossiblethroughregular
testing... tests have never been
moreaccurateandconvenient.”

T
hough the majority of Canadian
women are likely not familiar with
uterine fibroids,these non-cancer-
ous tumours will appear in up to 70
percent of women by the age of 50.
While the fibroids will not impact the health of
most women,unfortunately,for about 20 to 50
percent, the condition can lead to symptoms
such as heavy menstrual bleeding,pain,pelvic
pressure, difficult or frequent urination, and
even fertility issues.
For women suffering from the ill effects of
these uterine growths,if medications and radio-
logicinterventiondon’twork,itmaybenecessary
to undergo surgery.Surgery,however,is notwith-
outpotentialcomplicationsbecausewomenwith
uterine fibroids may also be anemic,potentially
duetoprolongedheavymenstrualbleeding.
“Approximately 24 percent or one in four
women having gynaecological surgery have
perioperative anemia,” says Dr.Sony S.Singh,a
gynaecologist from The Ottawa Hospital, who
emphasizes the importance of reducing anemia
before surgery to ensure a successful procedure.
“The bottom line is we want to make surgery as
safeaspossibleandgivethepatientthebestout-
come.Doingsurgeryonapatientwithanemia—
a low blood count — can lead to all sorts of prob-
lems,suchasbloodtransfusionrisksorimpaired
healing.Additionally,ifsomebodycomesinwith
a low blood count,their energy is low,and they
alsowon’t heal aswell after surgery.”
Reducing anemia
There are several medications and iron replace-
ment options that can help reduce the risk of
anemia before surgery. These options include
various medications that reduce or stop men-
strual bleeding,such as gonadotropin-releasing
hormone (GnRH) agonist therapy,which is now
indicated to improve anemia prior to fibroids
surgery. “GnRH agonists work by reducing the
amount of estrogen and progesterone that feed
the fibroids, and therefore they help control
bleeding. They also shrink the fibroids, along
with the uterus,which may actually make the
surgeryeasier,” says Dr.Singh.
“For example, if I had a patient who was 30
years old with heavy menstrual bleeding and
many uterine fibroids who wants to have a ba-
by,butshehaslowenergybecauseofalowblood
count… before surgery, we would give her iron
and want to stop her bleeding. Giving GnRH
agonists will help stop bleeding as we await
the operation. GnRH agonists may also make
the surgery easier to do and allow for less risk
of blood transfusion and other issues.” Other
medications (hormonal and non-hormonal)
working through separate methods may also be
offered and maybenefit patients.
Talk to your doctor
For patients with uterine fibroids undergoing
surgery,communication is key,says Dr.Singh.“If
womenaregoingtohavesurgery,it’sveryimport-
ant theylook into or discusswith their physician
options to reduce the harm of being anemic,be-
causeanemiaisaconditionthatneedstobetreat-
edandaddressedpriortosurgery.”
Sandra MacGregor
Uterine Fibroid Surgery and Anemia:
A Targeted Therapy
It takes commitment and a collaborative
approach to pursue possibilities.
That’s why AbbVie partners with peers,
academics, clinical experts and others to take
on the most complex health challenges.
Uniting the best of pharma with the boldness
of biotech, together we’re going beyond
conventional thinking to innovate end-to-end
Starting with science, we arrive at solutions
that help millions of patients around the world
live better.
Learn more at abbvie.ca
@abbviecanada
PEOPLE. PASSION.
POSSIBILITIES.
ADDRESSING
THE TOUGHEST
CHALLENGES IN
ENDOMETRIOSIS
UTERINE FIBROIDS
TAKES ALL OF US.
Scan here to watch
“Uterine Fibroids
– An Educational
Video” on YouTube
Dr. Sony S. Singh
(MD, FRCSC, FACOG)
Vice-Chair of Gynaecology,
The Ottawa Hospital

Ovarian Cancer Is Not a Women’s
Issue, It’s a Canadian Issue
C
ancer is a many-headed mon-
ster. It may never be truly de-
feated, but great strides have
been made in finding treat-
ment options for many forms
of cancer, allowing people to
live full lives after diagnosis or even recover
completely. Ovarian cancer, however, remains
the most lethal cancer affecting Canadian
women, with 56 percent of women diagnosed
not surviving fiveyears.In fact,there have been
very few substantial advances in medication in
decades — until now.
New treatments coming are now poised to
change that. Unfortunately, for many women,
the pace of government approval and funding
maymean these newtreatments arrive too late
in Canada — despite already being available
in over 30 other countries. “Women haven’t
had many new ovarian cancer treatment op-
tions over the last 30 years,” explains Elisabeth
Baugh, CEO of Ovarian Cancer Canada. “Five
Canadian women are dying from ovarian can-
cer every day.We have to change that.Women
with ovarian cancer deserve better.”
Know your risk
Part of the reason that ovarian cancer is so
deadly is because it often presents no symp-
toms until it has progressed quite severely,
making it particularly important for women
to know if they are at elevated risk.“All women
are at risk, but some are at greater risk,” says
Baugh. “Women are at greater risk when
they’re over 50, if there’s a family history of
breast,ovarian,endometrial,or colorectal can-
cer,if they are of Ashkenazi Jewish descent,or
if they have certain genetic mutations.”
Mona Sherkin of Ontario was diagnosed with
ovarian cancer four years ago.She was in all the
highest-riskcategories,andhastheBRCAmuta-
tion (which carries an up to 60 percent risk of
developing ovarian cancer), but didn’t learn
any of that until after the cancer sneaked up on
her. “I felt terrific.There was nothing internal
in terms of my body warning me.I was 58 and
I was probably in the best shape of
my life,” says Sherkin.“What makes
me crazy about this disease is that
with the amount of tumour that was
in me,it must have been growing for
over ayear and I felt nothing.Nobody
tellsyou anything about ovarian can-
cer.There’s not enough education out
there forwomen.”
Understanding and accelerating the
treatment landscape
Treatment for ovarian cancer cases like Mona’s
are complicated by the insidious nature of the
disease and the frequency of late-stage diagno-
sis.“If it’s diagnosedveryearly,it can be treated
very effectively with surgery and chemother-
apy,” says Dr. Amit Oza of Princess Margaret
Cancer Centre.“But when it is diagnosed later,
the long-term outcomes can be grim.”
New targeted treatment options, including
several that are particularly effective in women
with BRCA mutations, are now beginning to
change that. “The conventional treatment for
some time has been that you would reduce the
burden of the disease with chemotherapy and
thenwaitandseeifthediseasecamebackagain,”
saysDr.Oza.“Nowwe’retryingtobreakthatcycle
by giving maintenance treatment to reduce the
likelihoodofthediseaserecurring.”
Monawas fortunate enough to get on a clinical
trialforoneofthenewtherapies,andthenreceive
it afterwards through the compassionate care
program.Fouryears after diagnosis,havingcoped
withtworoundsofchemotherapyforreoccurring
ovarian cancer, she is once again feeling strong
and hanging out at the golf course — her remain-
ingtumoursbeingkeptincheckbyhertreatment.
However, not all Canadian women have the
same access.“We’re calling on all the provincial
andterritorialgovernments,drugmanufacturers,
and private insurers to weigh the evidence and
move quickly on approving these treatments,”
says Baugh.“As science accelerates,this need for
prompt approval is going to keep coming up
more and more often as new treatments con-
tinuetobediscovered.WewantCanadianwomen
torightlybenefitfromthespeedofscience.”
From Mona’s perspective, these new treat-
ments mean the future looks bright. “Ovarian
cancer is part of my life,and will be for the rest
of my life, but it will not dictate how I live my
life,” she says. “It really isn’t a death sentence
any more.I know that if this treatment doesn’t
work for me,though I’m hopeful it will,there is
something newcoming down the pipe.”
The goal must be to deliver that same degree
of hope to allwomen across Canada.
This article was made possible with support from AstraZeneca Canada.
Mona Sherkin was diagnosed with ovarian
cancer four years ago. She was in all the highest-
risk categories, and has the BRCA mutation,
but didn’t learn any of that until after the cancer
sneaked up on her. Photo | Big Red Oak Inc.
“Ovarian cancer is part of my
life, and will be for the rest of
my life, but itwillnotdictate
howIlivemylife.”
D.F. McCourt

Women's Health in Chatelaine Magazine

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