The relative risks of thrombotic stroke and myocardial infarction (MI) are higher among users of hormonal contraception, although absolute risks remain low, a Danish study conducted at Copenhagen University  showed.

Use of oral contraceptives combining low-to-moderate doses of ethinyl estradiol and various progestins was associated with up to 2.3 times the risks of thrombotic stroke or MI compared with non-use.The type of progestin in the pill had little effect on the risks, the researchers reported in the June 14 issue of the New England Journal of Medicine.

To put the risk in perspective, they estimated that among 10,000 women taking a pill combining desogestrel with ethinyl estradiol at a dose of 20 μg for 1 year, two will have arterial thrombosis and seven will have venous thrombosis.

"Although venous thrombosis is three to four times as frequent as arterial thrombosis among young women, the latter is associated with higher mortality and more serious consequences for the survivors," they wrote. "Therefore, these figures should be taken into account when prescribing hormonal contraception."

Several previous studies have examined the relationship between hormonal contraceptive use and the risk of venous thromboembolism. But fewer have looked at arterial complications like thrombotic stroke and MI, and the results have been mixed.

In an accompanying editorial, Diana Petitti, MD, MPH, of Arizona State University in Tempe, said that the absolute increases in the risks of thrombotic stroke and MI observed in the study were small."None of the hormonal contraceptives studied ... were associated with an excess risk of stroke that was unacceptable, considering their contraceptive and noncontraceptive benefits," she wrote.

And, she added, evidence from previous studies "shows that the small risk could be minimized and perhaps eliminated by abstinence from smoking and by checking blood pressure, with avoidance of hormonal contraceptive use if blood pressure is raised."

The researchers acknowledged the study was limited by possible diagnostic misclassification, the potential for a time lag between the date of prescription and when the contraceptives were started, the lack of information on body mass index, and the incomplete information on smoking status.

Source reference:
Lidegaard Ø, et al "Thrombotic stroke and myocardial infarction with hormonal contraception" N Engl J Med 2012; 366: 2257-2566.

Several health experts are proposing to make the birth control pill available in the U.S.  without a prescription (as they are in many parts of the world). The American College of Obstetricians and Gynecologists (ACOG)  released a statement calling for oral contraceptives to be sold over-the-counter, no longer requiring a doctor’s prescription.

ACOG considered a host of issues, including the safety of birth control pills; whether pharmacists should have a screening role (which could raise the moral objection issue) ; adherence to taking the pill; whether women would skip other preventive care if they didn’t visit a health care provider for a prescription; and cost.

ACOG addresses frequent objections to OTC oral contraceptives by concluding that “several studies have shown that women can self-screen for contraindications,” and “cervical cancer screening or sexually transmitted infection (STI) screening is not required for initiating OC use and should not be used as barriers to access.”

ACOG recognizes  making the pill non-prescription might increase the cost for women who have health insurance which would only pay for prescribed drugs, and would have to pay out-of-pocket for the over-the-counter version.

The National Latina Institute for Reproductive Health issued this response to that concern:    The recommendation that birth control be available over-the-counter supports what we know about Latinas and contraception: over-the-counter access will greatly reduce the systemic barriers, like poverty, immigration status and language, that currently prevent Latinas from regularly accessing birth control and results in higher rates of unintended pregnancy.

Pre-Prescribing Emergency Contraception to Teens
On a similar issue, the American Academy of Pediatrics(APP), issued a statement recognizing high teen birth rates in the United States and barriers to access to emergency contraception for adolescents 17  and younger. The AAP strongly admonishes pediatricians who refuse to discuss or provide contraception to teens based on their own beliefs, stating:

• Pediatricians have a duty to inform their patients about relevant, legally available treatment options to which they object and have a moral obligation to refer patients to other physicians who will provide and educate about those services. Failure to inform/educate about availability and access to emergency-contraception services violates this duty to their adolescent and young adult patients.

• The AAP recommends that physicians provide prescriptions to emergency contraception like Plan B in advance, so teens have it ready if and when the need arises. They also urge physicians to provide accurate information to teens on this topic, and, “At the policy level, pediatricians should advocate for increased nonprescription access to emergency contraception for teenagers regardless of age and for insurance coverage of emergency contraception to reduce cost barriers.”

HHS Urged to Remove Restrictions on Emergency Contraception
Finally, a petition is circulating urging the U.S. Department of Health and Human Services to remove restrictions on emergency contraception and make it available to women of all ages without a prescription.

SOURCE:  Our Bodies, Our Selves

Mesothelioma is typically regarded as a men’s cancer.  The primary cause – occupational asbestos exposure – was the biggest threat in male-dominated industries, such as mining, construction and factory work. During the early and mid-20th century, when asbestos was most heavily used by manufacturers, women made up only a small percentage of the workforce.  However, female patients continue to come forward, sharing their stories of how they ended up with this aggressive disease.

Women and Asbestos Exposure
For women, asbestos exposure was more likely to come from a secondhand or environmental source.   Secondhand asbestos exposure includes contact with the skin, hair or work clothing of another asbestos-exposure individual. Many female mesothelioma patients recall hugging their parents after they worked with asbestos or washing their spouses’ asbestos-contaminated clothing.

Other female mesothelioma patients attribute their disease to environmental asbestos exposure. In towns with thriving asbestos mines, the fibers often contaminated the air and soil throughout the community. Women may have purchased asbestos-laden gardening soil or taken their children to play in parks where the fibers were present in the dirt.

In one study, these various types of environmental exposure led to a much higher risk for mesothelioma in women; females had a relative risk of 159.9 per 100,000, while men had a relative risk of 114.8 per 100,000.

Although they were less likely to handle asbestos products in the workplace, women did face exposure risks from certain household products. Until the 1980s, items such as talcum powder and hairdryers contained asbestos fibers. Regular use may have led them to develop illness several decades down the road.

Like men, women typically develop asbestos-related diseases 20 to 50 years after they were exposed. However, some studies suggest that women have a better long-term survival with mesothelioma. As a result, some medical professionals recognize female gender (along with younger age and early cancer stage) as a positive prognostic factor for the disease.

Author bio: Faith Franz has spent nearly two years researching and writing for The Mesothelioma Center.   Check out our up-to-date tweets about mesothelioma cancer here

Sources:
Smith, D. (2002). Women and Mesothelioma. Chest; 122 (6).

Wolf, A. S., Richards, W. G., Tilleman, T., R., Chirieac, L., Hurwitz, S., Bueno, R. and Sugarbaker, D. (2010). Characteristics of Malignant Pleural Mesothelioma in Women. Annals of Thoracic Surgery; 90. 

A 9-year-old girl from Western Scotland named Martha ‘Veg’ Payne started a blog called NeverSeconds that caught the attention of Scotland’s politicians. Her blog documented her public primary school’s lunches, chronicling the low points and the high points. Because she was documenting some of the unhealthy and unappetizing lunches her school was serving to the students, she received some negative feedback from Scotland's politicians and her school.  With her father owning a farming property, and a physician for a mother, Martha is no stranger to nutrition and health. She began her blog in the early part of May and it went viral in just a few days. Within weeks, Martha had a million viewers. By the middle of June, her viewer count jumped to two million and she received support from television "cheflebrity," Jamie Oliver. She's made her way into coverage from The Telegraph, Time, the Daily Mail and numerous food blogs.

This was not all the attention she received. Once the school found out what was going on, she was forbidden to bring her camera to her classes. The school also insisted she shut down her blog. Martha, known as ‘Veg’ on her blog, spoke about the incident stating she was taken to her head teacher’s office and was told she was not allowed to take any new photos of her school dinners. This came about due to a newspaper’s headline that particular day.

Here is a child who is passionate about nutrition and motivated to make positive changes. She was able to influence a change of the cafeteria food in her district within two weeks. In fact, children in her school were allowed unlimited fruit, salads and bread. Martha also got children all over the world excited about their school lunches. Over the seven-week life of her blogs, she received photos of school lunches from Japan, Germany, Finland, Spain, Illinois and Washington State, just to name a few.  Martha sounds like our kind of girl!