Women's Health Archive

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

Image: © Auremar/Thinkstock
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.

Research we're watching

Although hormone therapy was once thought to help preserve cognitive function after menopause, there is mounting evidence to the contrary, including a recent report from the Kuopio Osteoporosis Risk Factor and Prevention Study.

Researchers in that project sent questionnaires to all women ages 47 to 56 who lived in the Finnish province of Kuopio in 1987. The women completed questionnaires every five years, providing information about their lifestyles, medication use, and illnesses. The researchers checked the information in the questionnaires against prescription registries and medical records up to 2009.

Data from several surveys indicate that the percentage of women who drink has been increasing for decades. The numerous health effects associated with alcohol consumption mean that women should be especially attentive to how much they drink.

Ask the doctor

Q. I've heard that bioidentical hormone pellets injected near the hip are more effective than bone-building drugs in stopping bone loss and preventing hip fracture. Is this true?

A. The FDA hasn't approved hormone pellets for preventing or treating bone loss. Moreover, there are no randomized controlled trials on record, so we don't know whether hormone pellets are more effective — or even as effective — as the FDA-approved medical therapies. Finally, there aren't any published reports explaining how the hormones are metabolized in the body or the side effects they may have.

Ask the doctor

Q. I have been smashed, squashed, pulled, and tugged annually for 25 years. Why isn't there a better way to take a mammogram?

A. We hear you! Compression mammography has been the "gold standard" for decades for one reason — it works. Flattening the breast makes ductal tissue easier to distinguish and reduces the amount of radiation required to do so. Studies have demonstrated that it is the most effective approach to breast cancer screening.

Hemorrhoids won't go away, but some simple measures can help to prevent and ease flare-ups.

 Image: © Wavebreakmedia/Thinkstock

By some estimates, about half of people over age 50 have hemorrhoids — swollen blood vessels on the outer rectum and anus. Women are more likely than men to develop hemorrhoids, probably because hemorrhoids commonly occur during pregnancy. However, they are less likely to seek medical treatment for them.

Not all hemorrhoids cause problems. One study of people undergoing colonoscopy found that more than half of people whose tests revealed hemorrhoids were unaware that they had them. However, when hemorrhoids become inflamed, they can make bowel movements — and even sitting — quite painful.

Research we're watching

Ductal carcinoma in situ (DCIS) differs from breast cancer because it is noninvasive, so it cannot spread to other parts of the body. However, it can progress to an invasive breast cancer, which can be life-threatening. Researchers from the Netherlands Cancer Institute wanted to determine how DCIS affected long-term survival.

The team studied almost 10,000 postmenopausal women who were diagnosed with DCIS between 1989 and 2004. They tracked the patients over an average of 10 years and compared their death rates with the expected mortality rates of the general population. They found that women who had been treated for DCIS had a 2.5% risk of dying of breast cancer over 10 years and a 4% risk at 15 years — rates that were higher than in the general population. But they also found that DCIS survivors had a 10% lower risk of dying from any cause compared with the general population. They presented their results Jan. 27, 2017, at the European Cancer Congress.

If you are thinking about getting pregnant, you can do many simple, effective things right now to improve your chances of conception, because lifestyle can have profound effects on the reproductive functions of women and men. This means that increasing your fertility potential is something that you both can do without outside help. In addition to adopting a fertility-boosting diet and getting into the fertility zones for weight and exercise, there are a number of lifestyle choices you can make for improving fertility naturally.

Give up nicotine, marijuana, cocaine, and steroids

Tobacco smoking has been linked to reduced fertility in both women and men. In addition, a recent British study has found an association between smoking and stillbirths, low birthweight babies, and sudden infant death syndrome (SIDS). A woman who smokes is likely to have less chance of becoming pregnant and giving birth when treated with in vitro fertilization (IVF) than a woman who doesn't smoke. This is especially true if she smokes twenty or more cigarettes a day. A mechanism that may link cigarette smoking and reduced pregnancy rates following IVF is the observation that smoking appears to accelerate the rate of egg loss. Women who smoke have the elevated hormone levels that indicate a depleted supply of eggs and prematurely aged follicles.