Women have many unique health concerns — menstrual cycles, pregnancy, birth control, menopause — and that's just the beginning. A number of health issues affect only women and others are more common in women. What's more, men and women may have the same condition, but different symptoms. Many diseases affect women differently and may even require distinct treatment.
We tend to think of breast cancer and osteoporosis as women's health diseases, but they also occur in men. Heart disease in a serious concern to both men and women, but risk factors and approaches to prevention are different. Women may also have specific concerns about aging, caregiving, emotional health issues, and skin care.
Women's Health Articles
With summer's approach come plans for travel, including flying long distances. But the prospect of a long flight often raises health concerns. Especially in passengers who are older or have certain conditions, air travel and the related stress can have an impact on health. Here are a few trouble areas and some precautions you can take.
Deep-vein thrombosis (DVT). Not all experts agree on an association between DVT (blood clots in the legs) and air travel. Symptoms may not occur for several days, so it's difficult to establish a cause-and-effect relationship. If there is one, it's likely due to prolonged inactivity. Limited airline space can discourage moving about. Dry cabin air may also increase the risk of DVT.
Prolonged inactivity slows circulation, allowing small clots to form in the legs and feet. The body's own clot busters kick in for most people, but in people with certain risk factors, the clots can get big enough to block a vein. These include cancer, heart disease, infection, pregnancy, and obesity, as well as recent injury or surgery. Smoking also raises the risk, as do birth control pills, selective estrogen receptor modulators, and postmenopausal hormones.
Inflamed vaginal tissue may not be something most women want to talk about, but it can be painful and life altering for those who have it. Atrophic vaginitis, the medical term for this condition, occurs as a result of deterioration of the vaginal tissue. It's a common condition in postmenopausal women because as estrogen levels drop, the tissue that lines the vagina becomes thinner and more easily damaged. The top layer of cells is often lost entirely, exposing the layer below, which is more vulnerable to inflammation or infection. Vaginal secretions also decline, which can make intercourse painful. Women with atrophic vaginitis may also experience vaginal itching, burning, frequent urination, or vaginal discharge.
Women can treat this condition topically with estrogen creams, tablets (Vagifem), or an estrogen-releasing ring placed in the vagina (Estring). Oral estrogen, available with a doctor's prescription, will also restore vaginal tissue. Vaginal lubricants offer an alternative for women wary of using estrogen. Moisturizers such as Replens, Astroglide, and Lubrin can reduce symptoms and make sexual intercourse more comfortable. They are available over the counter.
Sexual activity may also help preserve the vaginal epithelium, presumably by increasing blood flow to the area. A study of 52 postmenopausal women found significantly less vaginal atrophy among those who had intercourse more than 3 times a week than among those who had intercourse less than 10 times per year. Sexual activity also helps maintain an acidic vaginal climate, which offers some protection against infection.
Treating PMS:Dr Rigotti's AdviceI generally recommend that a woman suffering from PMS start by paying attention to lifestyle factors. Women spend much of their lives caring for others and need to be reminded how important it is for them to take extra care of themselves, particularly at the time of the month when they feel most vulnerable.This means simple things like getting regular aerobic exercise; avoiding caffeine, alcohol, salt, and concentrated sweets; eating frequent small meals instead of a few large meals a day; and practicing stress reduction techniques such as the relaxation response. Adding a supplement such as vitamin B6 to their diet also helps some women.
If several months of following these steps are not enough to control symptoms, I usually recommend trying an SSRI (selective serotonin reuptake inhibitor)type antidepressant medication as the next step. There is clear evidence that these drugs help, especially with mood swings and other psychological symptoms that are often the most troublesome.
Nancy Rigotti, MDMassachusetts General HospitalHarvard Medical School
When you are alone and have to perform cardiopulmonary resuscitation (CPR), your primary effort should be compressing the chest to help the person's heart pump blood. If there is a second person helping, providing breaths can be done at the same time as compressions are performed.
The brief review of CPR on the following pages can help you in an emergency; however, this information should not take the place of a certified course in CPR.
Immediate care Assess the situation. Call out for someone to get help or call 911 yourself if the person does not seem to need immediate assistance. You can determine this by gently shaking the person and asking in a loud voice, "Are you OK?" If there is no response, begin CPR and continue until help arrives.
ITEMS TO GATHER:
Birth of the Placenta
If you are called on to help deliver a baby, remember that childbirth is a natural process and that your role is to assist the woman and offer encouragement. If a woman's contractions are very strong and 2 to 3 minutes apart or the water bag (amniotic sac) has broken, birth is very near. If the woman tells you that the birth will happen very soon, believe her.
You will see quite a bit of blood, which is normal. You may see bloody fluid coming from the vagina before and during the birth; this is also normal.
This list describes your priorities in an emergency situation. Follow these steps:
Each year 3.5 million women have some degree of abnormality on their Pap smear the test most commonly used to screen for cervical cancer and require additional attention. But until 2001 there were no national guidelines on the best way for clinicians to treat these women.
The American Society of Colposcopy and Cervical Pathology brought together experts in cervical cancer prevention to develop comprehensive specifications. The guidelines they created could make things easier for women who have inconclusive Pap smear results.
The most common abnormal Pap smear result, occurring in about 1 in 20 tests, is called atypical squamous cells of undetermined significance (ASC-US). While most women with ASC-US do not have a significant cervical lesion and only about 1 in 1,000 have cervical cancer, they are at considerable risk for a high-grade cervical cancer precursor lesion and require some form of follow-up.
Researchers continue to unravel the web concerning the use of oral contraceptives and the risk of breast cancer. A study published in June 2002 indicated that birth control pills don't increase the risk of breast cancer for women in the general population (see August update). But a new study published in the December 4, 2002, issue of the Journal of the National Cancer Institute shows oral contraceptives can increase the risk of breast cancer in women with a particular genetic mutation.
The study examined whether the use of oral contraceptives increased the risk of breast cancer in women with a mutation in the BRCA1 or BRCA2 gene. Women who have such a mutation are already known to have a high risk of developing breast cancer and ovarian cancer. A person inherits these types of gene mutations.
The study involved 1,311 pairs of women who have the BRCA1 mutation, BRCA2 mutation, or both. Each pair of women shared certain characteristics, including mutation type, age, country, and history of ovarian cancer. Each pair included one woman who had been diagnosed with breast cancer and one who had not. Participants completed a questionnaire regarding their use of oral contraceptives based on their memory.
Women have a new choice for birth control. Late last year the FDA approved the intrauterine device (IUD) Mirena. Mirena is a T-shaped plastic device placed in the uterus by a physician that releases small amounts of the hormone levonorgesterel to block conception. Although not the first hormonal IUD, Mirena only needs to be replaced once every five years. The others, in contrast, must be changed yearly. The manufacturer, Berlex Laboratories, reports less than 1% of women become pregnant while using Mirena.Physicians can easily remove the IUD. And once its extracted, a woman can again become pregnant. According to Berlex, eight out of ten women who are trying to conceive will become pregnant within the first year after Mirena is removed.Mirena is not for everyone, however. Women with a history of pelvic inflammatory disease or a previous ectopic pregnancy (when the embryo grows outside the uterus) should not use IUDs. Furthermore, they dont protect against sexually transmitted diseases. Possible side effects include spotting or missed periods.June 2001 Update