Women's Health Archive

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Research we're watching

A long-term study from researchers at Johns Hopkins University School of Medicine has found that men's hearts typically grow with age, while women's shrink. The researchers used magnetic resonance imaging (MRI) to study the left ventricle—the main pumping chamber of the heart—in around 3,000 men and women who were enrolled in the Multi-Ethnic Study of Atherosclerosis. All of the participants—who ranged in age from 54 to 94—were free of cardiovascular disease when they entered the study. They had heart scans at the start and 10 years later.

Comparing the MRI scans of men and women, the researchers found that both had declines in left ventricular volume (the amount of blood the chamber holds) over the decade. However, the mass of the ventricle itself increased in men, while it decreased slightly in women. And having a bigger heart seemed to be a disadvantage. It was associated with higher blood pressure and body mass index and lower levels of HDL (good) cholesterol. The study was published online October 20, 2015, by the journal Radiology.

Ask the doctor

Q. I'm a 48-year-old woman, and I've never had a mammogram. Different guidelines seem to say different things. What do you recommend?

A. You're right, there are several different guidelines. Probably the two most often consulted by doctors are those of the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS). Recent changes by the ACS bring its recommendations nearer to those of USPSTF. They disagree slightly about you. ACS says you should have a mammogram (because you are over 45), but USPSTF says to begin at age 50. Both expert committees stress that these recommendations apply only to women who are not at extra risk of breast cancer (extra risk includes, for example, having a parent, sibling, or child who's had breast cancer). If a woman is at extra risk, she should start getting mammograms earlier.

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News briefs

The guidelines for routine breast cancer screenings are changing again. The American Cancer Society (ACS) published its new recommendations Oct. 20, 2015, in The Journal of the American Medical Association, suggesting that women at average risk for breast cancer now wait until age 45 to begin getting yearly mammograms (it had been age 40) and then get yearly mammograms until age 54. After that, the ACS now recommends that average-risk women ages 55 to 74 transition to screening every other year (instead of annually). It's a big shift for the ACS, and the recommendations are now more in line with the guidelines that came from the U.S. Preventive Services Task Force (USPSTF) in 2009, which recommended mammograms every two years for average-risk women ages 50 to 74 and advise against routine screening before age 50 in these women. The USPSTF guidelines have been controversial since they came out. But no one is saying that women at increased risk for breast cancer should wait to get a mammogram; it's a decision that must be made by a woman and her doctor, based on her risk factors. One other big change to the ACS guidelines: that women continue screening mammography only if they have a life expectancy of 10 years or longer.

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Research we're watching

Women who have heart attacks before age 60 may be less likely to receive a lifesaving procedure to restore blood flow to the heart (an angioplasty plus a stent) than men in that age group, according to a study in the Oct. 26, 2015, Journal of the American College of Cardiology. (Stents are tiny mesh tubes that help keep arteries open.)

Data for the study came from a nationwide sample of more than 630,000 people ages 18 to 59 who had heart attacks. Younger women also were more likely to die in the hospital compared with younger men (4.5% versus 3%, respectively). However, men may be more likely to die before reaching the hospital than women, which may partly explain that difference, the researchers say.

Q. What do you know about taking extra folic acid to boost the immune system?

A. Folic acid is the synthetic form of folate, a B vitamin that occurs naturally in some foods, including vegetables, fruits, and dried beans and peas — and is essential for health. Folate is vital for the production and maintenance of our bodies' cells, especially during rapid periods of growth, such as pregnancy and infancy. It's needed to make DNA and RNA, the genetic material that dictates cell functions, and it helps prevent changes to DNA that may lead to cancer.

Ask the doctor

Q. I've had some severe bouts of depression before my periods. I have done my own research and I am willing to try an antidepressant. What dosage of Sarafem or Prozac is usually given to treat this?

A. Selective serotonin reuptake inhibitors (SSRIs) are an excellent option for treating premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). In fact, most physicians now consider them first-line therapy. Many different SSRIs have been studied, including the one you asked about—fluoxetine (Prozac or Sarafem)—and they all appear to be equally effective.

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Ask the doctor

Q. Your recent article on recurrent urinary tract infections (UTIs) didn't mention much about urination. One of my friends told me that it could influence my chance of getting a UTI. Is that true?

A. Actually, your urination habits are a good place to start if you're trying to prevent UTIs. When sitting on the toilet, make yourself as comfortable as possible in a relaxed seated position—not a squat. Start the stream of urine by relaxing your pelvic floor muscles, rather than straining to urinate. Allow enough time for your bladder to empty completely.

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Research we're watching

A preliminary study published Sept. 14, 2015, in JAMA Internal Medicine reported that older women in Spain who ate a traditional Mediterranean diet enhanced with extra-virgin olive oil were less likely to be diagnosed with breast cancer. The study was part of a large Spanish clinical trial, Prevención con Dieta Mediterránea (PREDIMED).

PREDIMED looked at three different groups of women. One followed the Mediterranean diet plus extra servings of olive oil. A second followed the diet plus extra servings of nuts. Those in the third group were ad-vised to reduce their fat intake. The study followed about 4,300 women ages 60 to 80 for five years.

Research we're watching

A national survey published Sept. 30, 2015, in Menopause indicates almost a third of women who take hormones at menopause are using compounded hormones—estrogen, progesterone, or testosterone prepared by a pharmacist according to a prescription. Such preparations aren't FDA-approved.

The survey, conducted by the North American Menopause Society, asked 3,700 women ages 40 to 84 about their hormone use at menopause. They were queried about the benefits they expected, the benefits they actually received, the side effects they experienced, and their health histories.

Many public figures have begun speaking up about their experiences with miscarriage. While it’s wonderful that they’re breaking the silence, a recent survey has revealed that the general public still has a lot of misconceptions about this surprisingly common event. Dr. Hope Ricciotti shares her reactions to the survey results, and her advice to women experiencing miscarriage.