Entries for April 2008

Women are once again getting the bad word on hormone replacement therapy, with a new study linking HRT to strokes. Previous research had left a glimmer of hope that hormones didn't harm the cardiovascular system if they were taken at the beginning of menopause, a year or so after a woman's last period, rather than a decade or two later. But this new study calls that into question.

I find it ironic, though, that the study published this week in the Archives of Internal Medicine was based on data from the Harvard Nurses' Health Study—the very same study that years ago linked hormone use to all kinds of health benefits: protection against heart disease, Alzheimer's, colon cancer, and, yes, even strokes. The study has been tracking the health of more than 120,000 nurses over the past 30 years to see which particular health habits are beneficial and which detrimental. (As you can imagine, there's a lot of room for error even in this highly respected study.) Funny how the researchers, who are among the top epidemiologists in this country, have now come up with a completely different result that, as they write in the journal paper, is "nearly identical to that of the Women's Health Initiative." For those not familiar with WHI, it was the trial in which women were randomly assigned to take hormones or placebos to see whether hormones could prevent all those diseases of aging. As it turns out, WHI found that HRT caused more illness than it prevented.

There's bad news along with more bad news today for women worried about bone loss. A study published in the Archives of Internal Medicine finds that taking alendronate (Fosamax)—one of the most popular drugs to treat osteoporosis—nearly doubles a woman's risk of developing a dangerous irregular heartbeat. About 7 percent of those who used the drug developed atrial fibrillation, which can cause potentially deadly strokes, compared with 4 percent of those who never took it. The finding suddenly makes it look more perilous to counter bone loss. And since many conditions and medications can cause bone loss, plenty of women are left in a dilemma.

A second study in the same journal found that those who took the diabetes drugs rosiglitazone (Avandia) or pioglitazone (Actos) had double or even triple the odds of experiencing a hip, wrist, or other nonspinal fracture compared with those who didn't take either drug.

Yesterday the Senate voted unanimously to pass the Genetic Information Nondiscrimination Act (GINA), which after going back to the House for final approval is expected to be signed by President Bush as early as next week. This law will ensure that anyone who gets genetic screening tests will be protected from having that information shared with health insurers or employers. Up until now, women who tested positive for, say, one of the breast cancer genes could be denied insurance coverage or employment based on her predisposition to developing breast cancer years down the road.

In the works for 13 years, GINA got stalled along the way by a few obstinate lawmakers, as my colleague Dr. Bernadine Healy, U.S. News health editor, pointed out in this column. So consumer health advocates are greeting yesterday's news with a huge sigh of relief. "It's an extraordinary step forward and essential if we ever want to see the potential of genetic research," says Debra Ness, president of the National Partnership for Women & Families, a nonprofit advocacy group that has been lobbying for GINA's passage. "There are people afraid to enter research studies or get genetic testing, and we hope this legislation will alleviate those fears."

When a close friend of mine gave birth to a baby girl years ago (after having three boys), she gave all the credit for her baby's gender not to a roll of the dice but to a bestselling book she'd read called How to Choose the Sex of Your Baby. "It really worked!" she confided to me. She outlined the book's theories concerning the timing of sex a few days before ovulation, douching with water and vinegar, and standing on one's head after intercourse to improve the odds of "girl" sperm reaching the egg. OK, I made that last one up. But I'm dubious of gender selection methods and question the merits of a new study showing that skipping breakfast is more likely to yield girls. I'm surprised at how much the media are playing up these results in articles like this one and this one.

In the study, University of Exeter researchers found that British women who ate cereal every morning before they got pregnant had a somewhat higher intake of vitamins and minerals and consumed about 130 calories a day more on average than frequent breakfast skippers. The breakfast eaters were more likely to have boys than those who skipped breakfast and ate less. Both groups of women had similar body weights, which means those who conceived boy babies were probably more likely to be exercising and following an overall more healthful lifestyle. The researchers say evolution favors having boys during times of plenty and having girls during times of distress (i.e., when there's less food around).

News about life expectancy, up until now, has been rosy. Both women and men are living longer, six to seven years on average, than they were 40 years ago. A girl born in the U.S. today can expect to live to about 80—not too shabby. Yet a study out this week puts a damper on those numbers, which are just an average of everyone in the country. For folks in some counties, life expectancy is actually decreasing. And the news is particularly bad for women: In 180 counties across the country, women can expect to live to about 73, or about 1.3 years less than they did in 1983, according to data from the National Center for Health Statistics. These counties were primarily located in the deep South along the Mississippi River and in the Appalachian Mountains extending into the southern portion of the Midwest and into Texas.

When I was pregnant with my first child in 1995, every week seemed to last an eternity, as I worried whether I would make it through the first trimester without miscarrying (after going through that twice) and then how the kicking, nudging, hiccupping creature inside me was progressing. All I had was a fuzzy ultrasound image from the 20th week that, had I known what I was looking at, would have revealed my daughter's perfect little profile. Today's ultrasound technology has advanced to the point that radiologists can get clear 3-D videos of fetuses as they develop.

Moms-to-be sometimes walk away with these high-def images. But even if their ultrasound facility doesn't offer the latest technology, Your Developing Baby: Conception to Birth, a new book hitting stores this week, does. Using ultrasound images on nearly every page (3-D as well as the hazier 2-D), the illustrated guide walks women through the step by step development of a fetus from the speck of cells in the first early weeks to a fully formed baby about to be delivered. The authors, who are both professors of radiology at Harvard Medical School, clearly label and describe all of the anatomical features including the internal organs, far more than couples get on a typical sonogram snapshot.

As Washington's famed cherry blossoms give way to tulips and forsythia, spring's fertility gets me thinking about love. (French novelist Gustave Flaubert once said, "Love is a springtime plant that perfumes everything with its hope, even the ruins to which it clings.")

What is it, I wonder, that drives us to fall head over heels for that special someone? I decide to pose this question to Rutgers University anthropologist Helen Fisher, who analyzed the brain scans of people experiencing the insane rush of new love and wrote one my favorite books, Why We Love. (The brain scans showed that the caudate nucleus—the part of the brain associated with pleasure, arousal, and motivation to acquire rewards—gets activated when a person gazes at a photo of a sweetheart.)