Women's Health Archive

Research we're watching

It was once thought that hearing loss in older women might be linked to loss of estrogen and progesterone following menopause and that hormone therapy might reduce that risk. Recent results from the Nurses' Health Study II indicate just the opposite — that late natural menopause and the use of oral hormone therapy are linked to a higher risk of hearing loss.

Researchers enrolled 80,972 women ages 27 to 44 in 1991. All completed periodic questionnaires on their health status and lifestyles. By 2013, 18,558 participants had reported hearing loss. When the researchers analyzed the results, they found that women who underwent natural menopause at age 50 or older had a 10% greater risk of hearing loss than women who reached menopause before 50. Compared with nonusers, women who used hormone therapy — either estrogen alone or estrogen and progesterone — had a 15% greater risk of hearing loss if they used hormones for five to 10 years and 21% higher risk if they used them 10 years or longer.

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Although bone-weakening osteoporosis is quite common among older people, it isn't an inevitable part of aging. There's a lot you can do to shield your bones from this disease.

The best insurance against osteoporosis is building the highest bone density possible by your 30s and minimizing bone loss after that. But if you you're already in midlife or beyond, there is still much you can do to preserve the bone you have and perhaps even to replace lost bone. Daily weight-bearing exercise, like walking, is the best medicine. Getting enough calcium and vitamin D are two other critical strategies for keeping bones strong.

Building strength and power is key to healthy aging, both physically and mentally. It may be easier than you think.

We probably don't need to remind you that your body changes with age. Age-related muscle loss begins at around age 35 and progresses slowly — at about 1% per year. But after about age 60, muscle loses mass more rapidly, so that adults who don't do regular strength training may lose 4 to 6 pounds of muscle per decade. Moreover, the lost muscle is usually replaced by fat.

Studies show that strength training not only can slow muscle loss, it can also help prevent or control conditions as varied as heart disease, diabetes, arthritis, and osteoporosis. And recent research indicates that it can also improve cognitive function, especially when added to aerobic exercise. As we age, strength training helps to preserve mobility and reduce the risk of falling. "What has been shown is that if you're looking at mobility problems, the most beneficial exercises that are those that focus on progressive training for strength and power," says Dr. Jonathan Bean, an associate professor of physical medicine and rehabilitation at Harvard Medical School.

Ask the doctors

Q. I have fairly thick hair in the summer, but it seems to thin out in late fall. Is there anything I can do now to prevent losing hair in a few months?

A. Sadly, no. What you've experienced is common to all of us. On average, about 90% of the hairs on our heads are in the growing phase and about 10% are in the resting phase. After a few months in the resting phase, the hairs are shed. It's normal to shed up to 100 hairs a day.

By Hope Ricciotti, M.D., Editor in Chief

If you've come to expect a pelvic exam as a routine part of your annual well-woman physical, you may be surprised to learn that health experts disagree over whether it is necessary. The exam — in which the clinician inserts gloved fingers into the vagina to examine the cervix, uterus, and ovaries — has been routine for decades, but recently its benefits have been called into question.

In 2014 the American College of Physicians — an influential group of internal medicine specialists — issued a recommendation against routine pelvic examinations for women who aren't pregnant and have no unusual risk for or symptoms of pelvic diseases. However, the American College of Obstetricians and Gynecologists (ACOG) has stood by its longstanding policy recommendation — annual pelvic exams for women ages 21 and older — based on expert opinion. In March 2017, the U.S. Preventive Services Task Force — the pre-eminent medical guidelines organization — ruled that there is insufficient evidence to recommend either for or against annual screenings.

Research we're watching

A new study from researchers at the National Institutes of Health indicates that the rate of drinking in general, and binge drinking in particular, is rising faster among women ages 60 or older than among their male contemporaries. When the researchers analyzed data from National Health Interview Surveys from 1997 through 2014, they found that the proportion of older women drinkers increased at a rate of 1.6% a year, compared with 0.7% for older men. Binge drinking — defined as imbibing four or more drinks within two hours — increased by 3.7% annually among older women, but held steady among older men. The results were reported online March 24, 2017, by Alcoholism: Clinical and Experimental Research.

The researchers speculated that baby boomers, who tended to drink more than earlier generations did in youth, have continued their habits as they've aged. Whatever the reason, the trend doesn't bode well for older women's health. Because of biological differences, at any level of alcohol consumption, women have a higher blood alcohol concentration than men, putting them at greater risk of cognitive impairment and falls. It's a good idea to limit alcohol consumption to seven drinks a week, with no more than three drinks at a sitting.

Research we're watching

The FDA's medical device reporting program recently announced that as of February 1, it had received 359 reports of anaplastic large cell lymphoma (ALCL), a rare type of non-Hodgkin's lymphoma, in women who had received breast implants. Nine women had died of the disease. The FDA uses such reports to alert clinicians about potential significant side effects from approved drugs and devices, and as it gathers more information, the data may change. Many reports contained details of the implants, including whether the outside surface was smooth or textured and whether the filling was silicone gel or saline.

ALCL is usually found within a capsule of fibrous scar tissue that forms around an implant, not in the breast tissue itself. It appears to develop more frequently in women with textured implants, regardless of filling type.

The decision depends on several factors, including your breast cancer risk, life expectancy, and personal preferences.

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As you get older, your body isn't the only thing that's changing. So are the guidelines for taking care of it. Breast cancer screening guidelines are a case in point. The current U.S. Preventive Services Task Force (USPSTF) guidelines recommend a mammogram every two years for women ages 50 to 75 with an average risk of developing breast cancer. For older women, the USPSTF said there isn't enough evidence of the potential risks and benefits of mammography on which to base a recommendation.

Although breast cancer is a leading cause of death in older women, women over 75 haven't been included in studies of mammography. However, there is evidence that most breast cancers detected in older women are relatively slow growing and easily treated. While a mammogram performed today might detect a cancer that would not spread or metastasize for several years, the percentage of women who survive to that point decreases with each passing year.

Research we're watching

For many women with breast cancer, hair loss is the most distressing side effect of chemotherapy. Although cooling the scalp with ice packs has been tested, the technique has had limited success. However, a newer approach — wearing a cap connected to a cooling system that gradually reduces scalp temperature — has been more successful, according to two reports in the Feb. 14, 2017, Journal of the American Medical Association.

In one study, 67 of 106 women with stage I or stage II breast cancer who used the FDA-approved DigniCap during their treatment with taxane (Taxol and others) lost less than half of their hair. In comparison, 16 women who underwent the same treatment but did not wear the cooling cap lost all of their hair.