Politics, religion and contraception
Posted by on February 9, 2012 - 11:12am

As this blog predicted, both politics and religion have entered the women's health arena and it may result in a reduction in hard-fought-for services and advances for women.  Recently, the US Dept. of Health and Human Services modified the final ruling that requires new health insurance plans to cover contraceptive services without a copay or deductible by August 2012.   A temporary compromise, giving non-profit employers who, based on religious beliefs, do not want to include contraception access within their plans, an additional year to adapt to the new ruling.  While churches are exempt, hospitals and other large social services that may have religious affiliations will be expected to offer contraception in their plans by 2013 and they are not happy about it.  Religious leaders are rallying against the new ruling and women who need contraception are feeling outraged.

Since many of our readers are outside the U.S. and have universal access to contraception, let me explain.    Many women in the United States use contraception, especially the 'pill',  even though it is rarely covered by insurance requiring women to paying for it 'out of pocket'.  The average cost per year is $600 which is a financial challenge for many younger women.   In order to meet the needs of women with limited incomes,  social service programs have been providing contraception through local public health departments and agencies like Planned Parenthood but their resources are limited.    When viagra was released for men--and covered by most public and private insurance plans- it refueled the argument for insurance coverage for contraceptives.  It should be noted that contraceptives not only prevent pregnancy, they are often used to regulate difficult menses, reduce the risk of ovarian cancer, treat fibroids,  and reduce anemia due to heavy menstrual bleeding.

The role of churches, synagogues, and mosques is to provide a place to provide spiritual guidance to their members based on the teachings of their faith.   According to the US Constitution, these institutions have the freedom to preach and practice their faith.  Their members generally adopt those beliefs and practice them in their daily lives.  These institutions are not free to impose their beliefs on others who do not espouse their teachings.

Hospitals and social service agencies are not houses of worship.   Decades ago, most hospitals were run by religious orders.   Today,  hospitals (whether public, private or non-profit) are very large businesses that provides a valuable service and are paid for most of these services.   They take in patients no matter what their religion.     Hospitals also have to be competitive to attract the best employees by offering a comprehensive benefit package which includes a list of services that they may or may never use.     Hospitals are subject to legal business practices because they are corporations (registered with the local state)  and dependent on third party payers (insurance or public aid) to support their services.  Because they accept third party payment in the form of insurance, they need to follow certain federal and state regulations.     The days of the kinder and gentler Catholic hospital run by nuns is gone.  Now, religious hospitals are merging into big, competitive conglomerates.   As such, they are a business that just so happens to have a religious affiliation.  They do not preach theology in waiting rooms.   Staff members do not need to be a member of a certain house of worship to work there.

So here is a solution.   Hospital and care agencies include contraception (as per law) in their compensation package to employees as well as other attractive options like smoking cessation  to attract the best professionals possible.  Female non-smokers who need contraception use the contraceptive benefit,  but they do not use the smoking cessation benefit.   A Catholic employee who smokes, who does not believe in contraception,  chooses to use the smoking cessation benefit but not the pill.      If a mega hospital run by a religiously run corporation wants the best employees, they better focus on good business practices and leave the spiritual guidance to their affiliated houses of worship.    It's all about choice, a woman who firmly believes contraception is wrong, can simply say no.

P.S.  Word on the street is that government leaders are split on this issue with women more in favor of better access to contraception. The National Women's Law Center is requesting help with a petition that you can sign on by clicking HERE.

 

 

Quality of life after breast cancer treatments
Posted by on February 8, 2012 - 3:51pm

Researchers at UCLA's Jonsson Comprehensive Cancer Center found that the quality of life (QOL) in younger breast cancer patients is  seriously compromised and these women often suffer from severe psychological distress, infertility, premature menopause, a decrease in physical activity and weight gain.   The study found that the mental issues faced by younger breast cancer survivors were more serious than the physical impacts compared to a general age-matched population of women who didn’t have cancer and those more than 50 years old who did.

The study points to the need for oncologists to let these younger patients know from the beginning of their therapy what may happen to them after it’s finished, said study lead author Dr. Patricia Ganz, director of cancer prevention and control research at UCLA’s Jonsson Comprehensive Cancer Center.   “We know that educating and providing younger breast cancer patients with information about what they might experience once their treatment ends is very helpful,” said Ganz, who has been conducting research on quality of life after cancer treatment for 25 years. “If they know what to expect, their anxiety level will be greatly reduced. Up to now, oncologists have not done a good job of preparing these women for what will come.”

Reducing anxiety is crucial, Ganz said, as pre-clinical studies have shown that stress can promote cancer growth and spread in animal models. A study by Jonsson Cancer Center researchers published in 2010 in Cancer Research showed that chronic stress acted as a sort of fertilizer that fed breast cancer progression, significantly accelerating the spread of disease.   The need to prepare younger breast cancer survivors for any adverse effects they may experience and seek ways to address those problems is vital as more and more younger women are surviving their cancer diagnosis due to improvements in early detection and treatment, Ganz said.

“A cancer diagnosis can challenge younger women with issues that don’t impact older patients,” she said. “A younger breast cancer patient may have young children and may be worried about living to raise them to adulthood. A younger breast cancer patient may not have had children yet and may be faced with infertility following her treatment or may return to the dating scene following treatment. We need to find ways to reduce the stress and anxiety that dealing with these issues may create.”

For the Journal of the National Cancer Institute study, Ganz and her team did a review of studies that focused on overall quality of life, psychosocial effects, menopause and fertility-related concerns and behavioral outcomes related to weight gain and physical activity. The 28 studies reviewed were published between January 1990 and July 2010.  Ganz said that weighing therapies with the thought of quality of life after treatment in mind may help reduce some of the issues these younger women face.   “By tailoring adjuvant therapy regimens and giving cytotoxic therapy only to those who may benefit, we can mitigate some of these side effects, but the long life expectancy for these young women also provides a window of opportunity for cancer prevention and health promotion activities,” the study states.

Source:  UCLA Newsroom

Diabetes may impact hearing loss more in women
Posted by on February 7, 2012 - 12:57pm

Having diabetes may cause women to experience a greater degree of hearing loss as they age, especially if the metabolic disorder is not well controlled with medication, according to a new study from Henry Ford Hospital in Detroit.   Women between the ages of 60 and 75 with well-controlled diabetes had better hearing than women with poorly controlled diabetes, with similar hearing levels to those of non-diabetic women of the same age.The study also shows significantly worse hearing in all women younger than 60 with diabetes, even if it is well controlled.

Men, however, had worse hearing loss across the board compared to women in the study, regardless of their age or whether or not they had diabetes.  For the men in the study, there was no significant difference in hearing between those with diabetes that was well-controlled or poorly controlled, as well as those who did not have diabetes.   “Younger males in general have worse hearing, enough so to possibly mask any impact diabetes may have on hearing. But our findings really call for future research to determine the possible role gender plays in hearing loss,” says Dr. Handzo.

“A certain degree of hearing loss is a normal part of the aging process for all of us, but it is often accelerated in patients with diabetes, especially if blood-glucose levels are not being controlled with medication and diet,” says Derek J. Handzo, D.O., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.  “Our study really points to importance of patients controlling their diabetes, especially as they age, based on the impact it may have on hearing loss.”

According to the American Diabetes Association, nearly 26 million people in the U.S. have diabetes, and another 34.5 million have some degree of hearing loss. Signs of hearing loss include difficulty hearing background noises or hearing conversations in large groups, as well as regularly needing to turn up the volume on a radio or TV.

These results have been presented at a conference and not yet published in a peer reviewed journal, so they should be considered preliminary data.

Why boys talk later than girls: hormones?
Posted by on February 4, 2012 - 7:32am

Studies have shown that language development varies between the sexes, with males generally gaining language skills at a slower rate. Prenatal testosterone is known to influence fetal neurodevelopment, and preliminary studies have suggested that the hormone is associated with language delay.  Researchers from the U of Western Australia explored this issue in a large cohort of children.  They collected umbilical cord blood samples from 861 randomly selected births and measures the bioavailable testosterone levels.  As expected the males had a much higher level of testosterone in the umbilical cord blood than the females. For the following three years the parents completed an Infant Monitoring Questionnaire annually that measured communication (language), gross-motor, fine-motor, adaptive and social development.

As previously reported in other studies, a greater proportion of males had greater communication delay at all three assessments stages.  In addition to the language deficits, males were more likely to have delays in fine-motor function and personal-social skills at age 3.  Conversely, females exposed to the highest levels of testosterone had a reduced likelihood of having a language delay at that age.

This study suggests that high prenatal testosterone levels are a risk factor for language delay in male children.  In contrast to the increased risk for delay in males, higher levels of testosterone appeared to reduce the risk of language delay among females.

Males exposed to the highest testosterone levels were more than twice as likely to have a language delay at age 3, according to Andrew Whitehouse, PhD, of the University of Western Australia in Perth, and colleagues.

"These data suggest that high prenatal testosterone levels are a risk factor for language delay in males, but may be a protective factor for females," according to Whitehouse.   "Replication of these findings is essential, and may help refine our understanding of the level of testosterone that is associated with a detrimental effect on language development in boys."  The researchers expected the results in males but found it difficult to explain the protective effect in females.

They speculated that it might have to do with sex differences in how the brain lateralizes function across left and right hemispheres.
Source reference:
Whitehouse A, et al "Sex-specific associations between umbilical cord blood testosterone levels and language delay in early childhood" J Child Psychol Psychiatry 2012; DOI: 10.1111/j.1469-7610.2011.02523.x.

 

Breast cancer should not be about politics
Posted by on February 3, 2012 - 1:06pm

You’ve heard it before, but it’s a cliché that has earned its place: breast cancer knows no boundaries.  It affects all women – of all ethnicities, young or old, blue collar and professional.  Cancer doesn’t care where you worship, who you love, or how you vote.  Over 30 years ago I served for 13 years as the first executive director of a Chicago based breast cancer support organization called Y-ME.   Today, the Y-ME National Breast Cancer Organization is the largest breast cancer support organization in the U.S.

Recent news has had breast cancer organizations  answering a few questions about their political agenda.   For Y-ME,  the answer is: they don’t have one.  Instead, they have a mission, and a simple one: to assure that no one faces breast cancer alone.  No one.  They do this through the 24/7/365 toll-free hotline (1-800-221-2141).  They also have a website.

Y-ME does not care about your color, your insurance, your background, your voting record.  They care that you need someone to talk to, someone who understands.  When you have questions about breast cancer, you need information you can count on from someone you can trust.

The women who staff the Y-ME Hotline are a microcosm of all women and they all have been diagnosed with breast cancer at some time in their lives!!.   They are trained to provide easy-to-understand information about the complex topic of breast cancer diagnosis and treatment.   They are trained not to let their personal biases affect their job or their opinion of the women they speak to through the Hotline.

If the current political flap has you concerned, remember, there are others out there who truly are lifelines for women with breast cancer and I hope you continue to support them!.

Pfizer birth control pill recalled due to incorrect dosage
Posted by on February 1, 2012 - 10:42am

Pfizer Inc. announced today that it has voluntarily recalled 14 lots of Lo/Ovral®-28 (norgestrel and ethinyl estradiol)Tablets and 14 lots of Norgestrel and Ethinyl Estradiol Tablets (generic) for customers in the U.S. market. An investigation by Pfizer found that some blister packs may contain an inexact count of inert or active ingredient tablets and that the tablets may be out of sequence. The cause was identified and corrected immediately.

As a result of this packaging error, the daily regimen for these oral contraceptives may be incorrect and could leave women without adequate contraception, and at risk for unintended pregnancy. These packaging defects do not pose any immediate health risks. However, consumers exposed to affected packaging should begin using a non-hormonal form of contraception immediately. Patients who have the affected product (lot numbers available by clicking here) should notify their physician and return the product to the pharmacy.

These products are packaged in blister packs containing 21 tablets of active ingredients and seven tablets of inert ingredients. Correct dosing of this product is important in avoiding the associated risks of an unplanned pregnancy. Any adverse events that may be related to the use of these products should be reported to Akrimax Medical Information at 1-877-509-3935 (8 AM to 7 PM Mon-Fri CST) or to FDA's Med Watch Program either online, by regular mail or by fax.

How often should women have bone density tests?
Posted by on January 31, 2012 - 3:15pm

Experts recommend that older women have regular bone density tests to screen for osteoporosis. But it's been unclear how often to repeat the tests. A study of nearly 5,000 women now reports that patients with healthy bone density on their first test might safely wait 15 years before getting rescreened.

Osteoporosis is a disorder marked by weakened bones and an increased risk of fractures. More than 40 million people nationwide either have osteoporosis or are at increased risk for broken bones because of low bone mineral density (osteopenia). Osteoporosis is often called a “silent disease” because it usually progresses slowly and without symptoms until a fracture occurs. When low bone density is identified early through screening, lifestyle changes and therapies can help protect bone health and reduce the risk of fractures. That's why the U.S. Preventive Services Task Force recommends routine screening of bone mineral density for women ages 65 and older.

To help doctors decide how often to repeat bone density tests in women who don't have osteoporosis at their initial screening, a research team led by Dr. Margaret Gourlay of the University of North Carolina at Chapel Hill analyzed data on nearly 5,000 women, age 67 or older.  They divided the women divided into 4 groups based on initial bone density tests that were either normal or showed mild, moderate or advanced osteopenia. They were given 2 to 5 bone density tests at varying intervals during the 15-year study period.

As reported in the January 19, 2012, issue of the New England Journal of Medicine, the scientists found that less than 1% of women who initially had normal bone mineral density went on to develop osteoporosis during the study. Only 5% of those with mildly low bone density at the start made the transition to osteoporosis. Overall, the data suggest that women in these 2 categories might safely wait about 15 years before being rescreened for osteoporosis.

The scientists also found that about 1 in 10 women with moderate osteopenia at baseline developed osteoporosis within 5 years. For those with advanced osteopenia at the start, about 10% had developed osteoporosis within a year, suggesting that 1-year screening intervals might be advisable for this group.

“If a woman's bone density at age 67 is very good, then she doesn't need to be rescreened in 2 years or 3 years, because we're not likely to see much change,” Gourlay says. “Our study found it would take about 15 years for 10% of women in the highest bone density ranges to develop osteoporosis. That was longer than we expected, and it's great news for this group of women.”

These findings can help guide doctors in their bone screening recommendations. Other risk factors, such age, medications or specific diseases, would also influence screening frequency.
RELATED LINKS:

Osteoporosis:
http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/default.asp
Osteoporosis: The Bone Thief:
http://www.nia.nih.gov/health/publication/osteoporosis-bone-thief
Bone Mass Measurement: What the Numbers Mean:
http://www.niams.nih.gov/Health_Info/Bone/Bone_Health/bone_mass_measure.asp
Keeping Bones Strong and Healthy:
http://newsinhealth.nih.gov/2010/February/feature1.htm

Source:  NIH Research Matters,  a weekly update of NIH research highlights from the Office of Communications, National Institutes of Health.

Smoking teens can get text help to stop
Posted by on January 29, 2012 - 10:58am

Teens who start smoking could smoke more over their lifetimes– which may be made shorter as a result. It’s a good reason to quit.

But teen smoking expert Dr.Yvonne Hunt of the National Institutes of Health says quit programs are often designed for adults, and teens are not little adults – they think and talk differently, and have different smoking patterns.

So Hunt and her coworkers developed a tool to help teens quit. Teens spend a lot of time texting, so SmokefreeTXT sends six weeks of teen-friendly texts to their cellphones. Teens can register at teen.smokefree.gov.

"If teens want to enroll on the go, using their mobile phone, they can also text "QUIT" – Q-U-I-T – to the shortcode "IQUIT," which is 47848."

Of particular concern are the increasing number of young girls starting to smoke compared to young boys.   ALERT:   Young ladies who start smoking, you might think you look cool now but you won't look so cool when you get older and are walking around with an oxygen tank!  Quit while you are ahead!

Red or White (wine, that is) may make a difference
Posted by on January 27, 2012 - 7:54am

Drinking red wine in moderation may reduce one of the risk factors for breast cancer, providing a natural weapon to combat a major cause of death among U.S. women, new research from Cedars-Sinai Medical Center shows. The study, published online in the Journal of Women’s Health, challenges the widely-held belief that all types of alcohol consumption heighten the risk of developing breast cancer. Doctors long have determined that alcohol increases the body’s estrogen levels, fostering the growth of cancer cells.

But the Cedars-Sinai study found that chemicals in the skins and seeds of red grapes slightly lowered estrogen levels while elevating testosterone among premenopausal women who drank eight ounces of red wine nightly for about a month.   White wine lacked the same effect.

Researchers called their findings encouraging, saying women who occasionally drink alcohol might want to reassess their choices.  “If you were to have a glass of wine with dinner, you may want to consider a glass of red,” said Chrisandra Shufelt, MD, assistant director of the Women’s Heart Center at the Cedars-Sinai Heart Institute and one of the study’s co-authors. “Switching may shift your risk.”

In the Cedars-Sinai study, 36 women were randomized to drink either Cabernet Sauvignon or Chardonnay daily for almost a month, then switched to the other type of wine. Blood was collected twice each month to measure hormone levels.    Researchers sought to determine whether red wine mimics the effects of aromatase inhibitors, which play a key role in managing estrogen levels. Aromatase inhibitors are currently used to treat breast cancer.   Investigators said the change in hormone patterns suggested that red wine may stem the growth of cancer cells, as has been shown in test tube studies.

Co-author Glenn D. Braunstein, MD, said the results do not mean that white wine increases the risk of breast cancer but that grapes used in those varieties may lack the same protective elements found in reds.“There are chemicals in red grape skin and red grape seeds that are not found in white grapes that may decrease breast cancer risk,” said Braunstein, vice president for Clinical Innovation and the James R. Klinenberg, MD, Chair in Medicine.

The study will be published in the April print edition of the Journal of Women's Health, but Braunstein noted that large-scale studies still are needed to evaluate the safety and effectiveness of red wine to see if it specifically alters breast cancer risk. He cautioned that recent epidemiological data indicated that even moderate amounts of alcohol intake may generally increase the risk of breast cancer in women. Until larger studies are done, he said, he would not recommend that a non-drinker begin to drink red wine.

The research team also included C. Noel Bairey Merz, MD, director of the Women’s Heart Center, director of the Preventive and Rehabilitative Cardiac Center and the Women’s Guild Chair in Women’s Health, as well as researchers from the University of Southern California Keck School of Medicine and Hartford Hospital in Connecticut.

Take home message:  This is a small study and larger studies are needed.   However, if you do enjoy a glass of wine and don't want to give it up, perhaps choosing red over white would be choice---at least until new data becomes available!

New Collaboration Benefits Women Faculty in STEM
Posted by on January 25, 2012 - 4:15pm

A recent blog talked about the importance of support women in the STEM fields.    A good example is the new partnership between our University and the U of Chicago:

Northwestern University and the University of Chicago have launched the Chicago Collaboration for Women in Science, Technology, Engineering, and Mathematics, a three-year effort to enhance the recruitment and advancement of women faculty members in those fields.

“The University of Chicago and Northwestern are vitally concerned about the advancement of women in STEM at our respective institutions, and through this collaboration we have dedicated ourselves to making significant progress,” said University of Chicago Provost Thomas Rosenbaum, the John T. Wilson Distinguished Service Professor in Physics.  Important elements of the collaboration involve studying the apparent relative strengths and weaknesses of the respective institutions when it comes to fostering a positive climate for women in STEM, said Northwestern Provost Daniel Linzer.

The percentage of tenure-track women in STEM fields in 2010, according to University of Chicago officials, were basic biological sciences, 23 percent; physical sciences, 10 percent; and social sciences, 29 percent. The percentage of tenure-track women in STEM fields at Northwestern for the same period were biological sciences, 20 percent; engineering, 11 percent; physical sciences, 14 percent; and social sciences, 36 percent.

The new collaboration for women in STEM includes two yearlong programs: Navigating the Professoriate, for tenure-eligible faculty members; and Beyond Tenure, for tenured associate professors and professors.

The Navigating the Professoriate program is designed for tenure-track assistant professors in the biological, physical, and social sciences, and in engineering.  The program began Oct. 26 with a session on “The Art of Negotiating,” led by Victoria Medvec, executive director of Northwestern’s Center for Executive Women and a Professor of Management and Organizations at the Kellogg School of Management.   Statistically it’s fairly well documented that, on average, women do not negotiate as often or as well as their male counterparts.

The Beyond Tenure program kicked off Oct. 17 with a session titled “What’s Next: Imagining Your Career.” The program was designed to help tenured professors in the biological, physical, and social sciences become architects of their own destiny.  “The idea of taking the long view of your own career and figuring out what you need to do to get there after you’ve already gained a level of success is really a new perspective for many women,” said Peggy Mason, one of the program’s organizers and a professor of neurobiology at University of Chicago.   Women can decide to continue what they have already been doing, but other choices might include becoming a department head or dean, taking a leadership role in a professional society, directing a center, or starting a company.

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