Women's Health Archive

There is no evidence that so-called "bioidentical" alternatives to prescription hormones are either safe or effective.

Over the past couple of years, science has validated what many women already know: hot flashes and other symptoms of menopause can persist long after menstrual periods stop. It's also well established that estrogen—alone or combined with a progestin—is the most reliable treatment for menopausal symptoms and that, for most postmenopausal women, it is safe to take these hormones for up to five years at doses that relieve hot flashes.

But in 2002 the Women's Health Initiative reported that Prempro—an FDA-approved preparation combining synthetic estrogens with a progestin—increased the risk of cardiovascular disease and breast cancer. Since then, women have shied away from pharmaceutical companies' hormones. A third of women who use hormones for relief of menopausal symptoms are now choosing custom-mixed preparations from compounding pharmacies, according to research sponsored by the North American Menopause Society (NAMS). Women surveyed by NAMS commonly said they believed "natural" or "bioidentical" hormones from compounding pharmacies to be safer than the available FDA-approved hormones.

The U.S. Preventive Services Task Force recently updated their guidelines on screening for depression. This time around, they recommended widespread screening through primary care practices, plus gave special attention to women who are pregnant or recently gave birth. These matter-of-fact, achievable guidelines and goals have the potential to reap enormous health benefits.

Even though the use of lead has been regulated for many years, tragedies like the one currently ongoing in Flint, Michigan still occur. Exposure to lead in childhood can have health effects that can change a child’s life forever. We’ve listed steps you can take to keep your child — and everyone in your home — safe from lead poisoning.

Zika, a formerly rare and obscure virus, has recently spread throughout the Pacific islands and the Americas. Although Zika virus rarely makes people seriously ill, it’s been implicated in a huge rise in the number of birth defects in babies born to mothers who’ve had Zika. Although its impact in the U.S. is expected to be much less severe than in warmer climates, we’ve listed some tips to reduce your exposure to the type of mosquito that carries Zika.

Doctors may prescribe medicines for teenage girls — for example for acne, depression, or migraines — that are known to cause birth defects. While most parents and doctors hope that these young women avoid pregnancy for many reasons, adults need to help adolescent girls understand the risks of the medications they take and have frank conversations about sex and birth control.

Ask the doctor

Q. In your discussions of breast cancer screening, you never mention ultrasound. Is it an alternative to mammography?

A. No. Although the FDA has approved an automated breast ultrasound system to be used in addition to mammography for asymptomatic women with dense breasts, there are not enough published data about its effectiveness in screening to support its use. Moreover, ultrasound alone is not an alternative to mammography for routine breast cancer screening because ultrasound cannot pick up the small deposits of calcium (microcalcifications) that can be a sign of breast cancer.

Ask the doctor

Q. My daughter had a miscarriage a few months ago and since then she has been depressed and withdrawn. Do you know anything I can do to help?

A. Miscarriage can involve a difficult emotional recovery, and many women and their partners are surprised at the intensity of their feelings. Many women who have experienced a miscarriage feel that they have done something wrong. They may worry that the miscarriage resulted from stress or lifestyle choices they made during pregnancy. In fact, most miscarriages are the result of chromosomal abnormalities, structural abnormalities of the uterus, or maternal endocrine or autoimmune disorders.

By the mid-20th century, most births took place in the hospital. But increasingly, some women are choosing to have their babies at home in an effort to avoid seemingly unnecessary interventions and find an alternative to hospital environments. We don’t have the best data to assess the safety of home birth. But a recent analysis offers insights that can help women make choices based on what they value the most.

Image: iStock

Flibanserin is the first treatment of its kind. But it comes with a steep price tag and severe health risks.

It's now six months since the FDA approved flibanserin (Addyi), which is the first medication for sexual desire disorders. The drug was hailed as a "female Viagra," but is it living up to the hype? "It's not the solution we were hoping for," says Dr. Hope Ricciotti, editor in chief of Harvard Women's Health Watch and an associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School.

For years, there has been concern about the high rate of cesarean births — but just how many cesareans are too many? A recent study suggests that a cesarean rate of 19% is about right. The reasons for high cesarean rates may be related more to each hospital’s circumstances and processes than to other, more commonly cited reasons. If you’re concerned, find out the C-section rate at the hospital where you plan to deliver your baby.