Women's Health Archive

Ask the Doctor

Q. I've found lately that when I make a routine appointment with my doctor's office, I may be seen by a physician assistant or nurse practitioner instead of my doctor. I really don't have any complaints, but I'm wondering why they seem to be taking on things that my doctor used to handle. Is this a new trend?

A. In my practice, many patients see a nurse practitioner instead of me. The appointment might be for an initial visit to get established in the practice, for routine prenatal care, for an urgent issue such as a miscarriage, or for bothersome symptoms such as those from a persistent yeast infection. If a woman has complex medical issues, the nurse practitioner immediately consults me, and together we decide the best next steps.

Ask the doctors

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Q. My daughter is 38 years old and pregnant with her first child. Her due date is in two weeks, and her doctor has recommended that she have labor induced a week early. Why can't she just allow nature to take its course?

A. Having a baby when you're "older" can have some advantages—women may feel more secure with them-selves, their relationships, or their careers. However, expectant moms 35 or older—and their babies—have some increased pregnancy-related risks.

Each of your medications may be affecting how the others work, leading to harmful side effects and complications.

Each additional medication you take increases the risk of drug interactions.
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Are you taking more than one drug? Are you taking a few different types of medications? Are you seeing several different doctors? If so, you may be at increased risk for drug interactions, which occur when a drug, a supplement, or even a food affects the way your body processes a medication. Such interactions can make a drug more powerful—so that a standard dose becomes an overdose—or can render it less potent or altogether ineffective.

Intermittent tension-type headaches may seem like a consequence of everyday life. Yet you can minimize and even prevent them.

Tension-type headaches can be annoying, but they can often be nipped in the bud by using nonprescription pain relievers.
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Compared to migraines, tension-type headaches are a mere annoyance. They tend to be relatively mild and usually aren't accompanied by nausea or oversensitivity to light or sounds. Yet they can occasionally disrupt your day, making it difficult to concentrate on work or enjoy leisure pastimes.

Inflammation is an important link between obesity, elevated blood sugar, and type 2 diabetes.

Weight loss can reduce inflammation—a major contributor to diabetes.
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We've known for a long time that being overweight is a major risk factor for developing type 2 diabetes. But only in the last 20 years have researchers determined that metabolism and immune responses are linked and that chronic inflammation plays an important role in the development of obesity, diabetes, and related metabolic diseases. "Inflammation is not only associated with obesity, diabetes, and cardiovascular disease, but also precedes and predicts these conditions," says Dr. Allison Goldfine, head of the Clinical Research section at Harvard-affiliated Joslin Diabetes Center.

Research We’re Watching

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When specks of calcium appear in ductal tissue on mammograms, they can indicate a small cancer. But when calcifications are found in the breast arteries, they haven't been a cause for concern. However, in recent years, physicians have begun to suspect that arterial calcifications in the breast, like calcifications in the coronary arteries of the heart, can be an early sign of cardiovascular disease.

A team of researchers at Mount Sinai St. Luke's Medical Center in New York City studied the test results of 292 women who'd had digital mammography and non-contrast CT chest scans within a year. None of the women were known to have heart disease. They found that 42.5% of the women had evidence of breast artery calcifications on mammography, and of these, 70% also had evidence of coronary artery calcification on their CT scans. Moreover, 63% of those whose CT images revealed coronary artery calcifications had breast artery calcifications as well. Over all, the results indicated that women with breast artery calcifications are three times as likely as those who don't to have coronary artery calcifications. The study was published online March 24, 2016, by JACC Clinical Imaging.

Research we're watching

Mammograms, which are widely used to detect early breast cancer, may also be an effective tool for spotting early signs of heart disease, a small study suggests.

The study, in the April JACC: Cardiology Imaging, involved nearly 300 women free of heart disease. All underwent both a mammogram and a computed tomography (CT) scan of the chest. The mammograms showed calcifications (which look like a chalked line) in the arteries within the breast in just over 40% of the women. These artery calcifications are different from the irregular spots of calcifications that may indicate early cancer.

In its early stages, osteoporosis has no symptoms but causes millions of bone fractures every year, often resulting in loss of function and, disability and even death from the complications of the fracture. There are effective medications to prevent osteoporosis, but they can have serious (though rare) side effects. It’s best to talk discuss with your doctor to understand all your options and make an informed decision on how to best protect your bones.

Heart attacks strike men at younger ages than women. But survival rates are worse in women. Why?

Compared with men, women are less likely to recognize and act upon the symptoms of a heart attack.
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Imagine someone in the throes of a heart attack. If you picture a man clutching his chest in agony, that's understandable. At younger ages, men face a greater risk of heart disease than women. On average, a first heart attack—the most common manifestation of this prevalent disease—strikes men at age 65. For women, the average age of a first heart attack is 72.