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MONDAY, Aug. 25 (HealthDay News) -- Breast-feeding moms who take medicines containing codeine may be unwittingly risking the health of their infant, new Canadian research suggests.

The study indicates that a relatively rare genetic predisposition causes some women to metabolize codeine-laced drugs into morphine far faster than normal -- possibly harming the infant's central nervous system in the process.

In such cases, the threat of a morphine overdose appears to be reversible if the woman stops taking the medication. However, for mothers with the genetic vulnerability, the unabated ingestion of codeine and gradual build-up of morphine in a baby's system can prompt extreme sleepiness, abnormal breathing, and even death, the researchers warned.

The finding echoes a public health advisory issued by the U.S. Food and Drug Administration in 2007.

"Codeine itself doesn't have any pain-relieving effects, but our body changes it into morphine, and that's what combats the pain," explained study author Parvaz Madadi, a doctoral candidate in the department of physiology and pharmacology at the University of Western Ontario, in Canada.

"The problem is that your genetic makeup makes more or less of it," she noted. "So this is where the risk lies, because you can't know in advance what that predisposition would be, unless you would do a genetic test, which is not standard routine at this point. So while it would not be a problem in all cases, I would say that codeine cannot be considered a safe drug for some mothers who are breast-feeding their infants."

Madadi and a team of Canadian researchers published the findings in the Aug. 20 online issue of Clinical Pharmacology & Therapeutics.

The study authors pointed out that pain-relief medications are commonly prescribed for new mothers, given that almost half of all babies are delivered by either Caesarean section or episiotomy.

Given that the American Academy of Pediatrics recommends codeine as "compatible" with breast-feeding, and given that an estimated 80 percent of North American mothers breast-feed, Madadi and her colleagues calculate that upwards of 40 percent of all new mothers may be breast-feeding while consuming codeine for post-delivery pain.

Among that group, the researchers noted that between 1 percent and 10 percent of mothers with white European ancestry appear to have the risky genetic variant that causes morphine overproduction. Prior research indicates that the figure might be higher for other ethnicities.

Madadi noted that the current research effort was launched following the death of a Canadian infant due to the excessive ingestion -- following 12 days of breast-feeding -- of codeine-produced morphine.

In that instance, the mother, who was prescribed codeine-containing painkillers following an episiotomy, was later found to have the problematic genotype.

To explore the issue, the research team analyzed DNA samples collected from 72 mothers across Canada who consumed post-delivery codeine between 2004 and 2007. All the women also participated in a telephone survey to gauge the health of the mother and the central nervous system of the child -- both before, during and after codeine consumption.

Nearly one-quarter of the infants exhibited some central nervous system depression -- manifested by reduced alertness -- while breast-feeding during maternal codeine ingestion.

Among this group, mothers were found to have consumed, on average, almost 60 percent more codeine than mothers with healthy babies. This led the team to conclude, in fact, that excessive codeine consumption while breast-feeding can compromise a baby's health, whether or not the mother is one of the relatively few affected by a genetic predisposition to overproduce morphine.

But when honing in on the genetic front, the researchers indeed found that two mothers of symptomatic children carried the problematic genetic predisposition. In these two instances, the child's reaction to codeine consumption was particularly severe, with one baby ultimately dying as a result.

Julie Kable, an assistant professor of pediatrics at Emory University School of Medicine in Atlanta, said that the work represents "the wave of the future in science.

"The basic nature of this finding does not surprise me, given that this is where science is going, with a huge effort being made to better understand the interaction of one's genes with exposure to various substances. And it's not unheard of for this kind of science to lead to an altering of ob/gyn practice. It should be said, for example, that it wasn't so long ago -- in the 60s and 70s -- that women were actually given alcohol to stop premature labor. So, the possibility that this is true does create a burden to do the appropriate testing before we make such prescriptions."

More information

For more on codeine consumption and breast-feeding, visit the U.S. Food and Drug Administration.

SUNDAY, Aug. 24 (HealthDay News) -- With new "extended cycle" and "continuous" oral contraceptives on the market, women today can choose to have monthly withdrawal bleeding just four times a year -- or not at all.

To many American women of childbearing age, these options have tremendous appeal. In fact, more than two-thirds of women said they are interested in suppressing monthly bleeding, according to national survey results presented at an Association of Reproductive Health Professionals (ARHP) reproductive health conference.

"In the last 10 years, there really has been almost a revolutionary change in the opinions and the views of women regarding menstruation," observed Dr. Lee P. Shulman, professor and chief of reproductive genetics in the Department of Obstetrics and Gynecology at Northwestern University's Feinberg School of Medicine in Chicago.

"It's not just the more mature reproductive women desiring fewer withdrawal bleeds," said Shulman, immediate past chair of the ARHP. "Now that's becoming a more common desire among even younger women seeking hormonal contraception."

Oral contraceptives were initially designed to mimic the natural experience of menstruation. Women took 21 days of "active" pills, containing hormones, and seven days of placebo pills. During the hormone-free week, women experienced withdrawal bleeding, much like a true period.

Today's generation of oral contraceptives includes Seasonale and Seasonique, extended cycle products that reduce bleeding to four times a year, and Lybrel, a continuous-use product that stops monthly bleeding altogether. With Loestrin 24 Fe and Yaz, women still have a monthly bleed, but those "periods" are shorter.

Extended cycling, though, is not a new phenomenon. For years, doctors have being tailoring birth-control regimens to women's needs by having them skip the placebo week of traditional oral contraceptives and go on to a new pack. A woman going on her honeymoon, for example, or being deployed by the military, might seek to avoid bleeding and the need for sanitary protection. Extended regimens have also been used to treat women with endometriosis.

"The only difference recently is that we have these dedicated products," said Patricia Aikens Murphy, associate professor and the Annette Poulson Cumming Presidential Endowed Chair in Women's and Reproductive Health at the University of Utah College of Nursing in Salt Lake City.

Despite mounting interest, women in the survey also expressed some reluctance about the safety of suppressing monthly bleeding. By contrast, 97 percent of physicians who were surveyed said it's medically safe and acceptable.

Shulman attributes women's concerns about whether it's safe and natural to tamper with menstruation to conventional wisdom passed down by mothers and grandmothers. They'll hear about it and say, " 'You're not pregnant; you're supposed to have a period,' or 'Dammit, I had a period for 35 years; you're going to have a period for 35 years,' " he said.

Some women who try extended cycling really like it, because it reduces symptoms such as headache and bloating that occur during the placebo week, Murphy said. And there's some theoretical speculation that overall birth control effectiveness might be improved when women continue to use hormone-containing pills, she added.

"Many failures with birth control pills occur when that seven-day hormone-free interval gets extended longer and women actually run the risk of ovulating -- if you forget to start your pack right when you're supposed to," she explained.

One note of caution, though. These products are associated with a greater frequency of breakthrough bleeding and spotting, Shulman pointed out.

And there are other considerations. It takes most women a few months or more to stop having bleeding, said Susan Wysocki, president and CEO of the National Association of Nurse Practitioners in Women's Health in Washington, D.C.

"I liken it to buying a new pair of shoes," she said. "New shoes take breaking in. But once they are broken in, they are the shoes you like to wear. It takes time to break in a non-cycling contraceptive pill as well."

More information

The Association of Reproductive Health Professionals can tell you more about menstrual suppression  .

WEDNESDAY, Aug. 13 (HealthDay News) -- A satisfying sex life is possible as you age into your 70s and 80s, new research suggests.

Many older Americans are apparently taking advantage of that fact, because 68 percent of men between 57 and 85 reported having sex last year, as did 42 percent of women, according to the study's lead author, Edward Laumann, the George Herbert Mead Distinguished Service Professor of Sociology at the University of Chicago. And, Laumann added, more older women might have wanted to have sex, but there just aren't as many available older men for them to partner with.

"Healthy people can have reasonably satisfying sexual health for most of their lives," said Laumann. "There are challenges that arise, but it's not aging, per se, that's the issue. A decline in sexuality may be the canary in the mineshaft. Sexual problems may manifest before diabetes and high blood pressure."

The study findings were published in the current issue of The Journal of Sexual Medicine.

"It's definitely whether you're elderly or "wellderly" that makes a difference," said Dr. Virginia Sadock, director of the program of human sexuality at New York University Langone Medical Center in New York City. "Illness and medications make a difference in sex lives."

Other factors that can get in the way of a satisfying sex life later in life include having had a sexually transmitted disease, and having physical problems, mental health issues or relationship difficulties, the study found.

The study included information from 1,550 women and 1,455 men between the ages of 57 and 85. All participated in the National Social Life, Health and Aging Project.

Some highlights of the study include:

• Having had a sexually transmitted disease (STD) in the past nearly quadrupled a woman's odds of having sexual pain, and it tripled the odds a woman would have lubrication problems.
• In men, a history of STD was associated with five times the risk of finding sex unpleasant.
• In both older men and women, a common factor in sexual dysfunction and a decreased interest in sex was urinary tract syndrome.
• Both older men and older women reported that mental health issues affected their interest in sex.
• For men, relationship troubles also contributed to a lack of interest in sex and the inability to achieve orgasm.
• Drinking alcohol daily improved a women interest in and pleasure from sex. Alcohol didn't have that effect on men.
• Hispanic women were twice as likely to report pain during intercourse.
• Black men were twice as likely to say they weren't interested in sex and were more likely to report climaxing early.

"Sexual health is a harbinger of physical and mental health, and it plays an important role in the quality of life," Laumann said. "Older people don't just drop out of the picture. In general, if you're healthy, you can be sexually active."

Sadock added: "Don't assume that because you're older, your sex life has to be gone. If you're healthy and connected to someone, and you've had a pretty good sex life when you're younger, then you can have a pretty good sex life in old age."

More information

To read more about sex as you age, visit the U.S. National Women's Health Information Center.

SATURDAY, Aug. 2 (HealthDay News) -- The number of Americans newly infected with HIV each year is, and has long been, higher than what was previously assumed, U.S.health officials have announced at an international conference.

That's because the latest calculations have been arrived at via a new and improved method, they added.

Using the new method, researchers at the U.S. Centers for Disease Control and Prevention say that about 56,300 new HIV infections occurred in the United States in 2006 -- a figure 40 percent higher than the former estimate of 40,000 infections annually.

"This is the clearest picture we've ever had of new HIV infections occurring in the United States," said Dr. Richard Wolitski, acting director of the division of HIV/AIDS Prevention at CDC, which conducted the study.

"This is a wake-up call," he added. "We have to do more as individuals, communities and a nation to make sure we're doing everything we can to stop the further spread of HIV."

The new numbers don't mean that the epidemic is worse than previously thought, simply that the level of new HIV infections has remained stable but at a rate higher than was previously believed.

The findings were to be presented at the International AIDS Conference in Mexico City over the weekend. They will also appear in the Aug. 6 issue of the Journal of the American Medical Association (JAMA).

The CDC used new technology, approved by the U.S. Food and Drug Administration in 2005, that can distinguish recent from older HIV infections.

Although the number of new infections is higher than once thought, the populations bearing most of the burden remain the same, namely gay and bisexual men (of all races and ethnicities) and black men and women.

"The magnitude of new infections is larger than previously thought, but we have the same picture of who's at risk," Wolitski noted.

"These new CDC numbers lend credence to what public health officials have long been saying, that HIV is alive and well and thriving in certain communities in the U.S.," added Rowena Johnston, vice president of research for the Foundation for AIDS Research in New York City. "Using these advanced methods to paint a more accurate picture of the numbers of new HIV infections is important for working out where our prevention messages have worked, and where there is a need for improvement. It's time to take a precision strike approach towards HIV prevention in this country."

More information

There's much more on HIV/AIDS at the U.S. Centers for Disease Control and Prevention.