Entries for May 2008

The Department of Health and Human Services has declared this week National Women's Health Week, and though I think every week should be devoted to women's health, it's nice to have this recognized widely as a priority. Even Congress has resolved that women need to be more aware of new tests, screenings, and preventive health measures that will keep them well. Here's a listing of events that are going on nationally and in your local area. I've highlighted two news items relevant to your health:

My first thought when I read about new research out today on mammography and ultrasound was: Wow! Are mammograms really that lousy? It turns out that mammography can detect only about half of all breast cancers in women with dense breast tissue. Scary. By combining a mammogram with ultrasound, the success rate jumps to about three quarters, according to the study published in the Journal of the American Medical Association.

Indeed, the standard test is lousy in those unlucky women who have dense breasts, since tumors, which are also dense, are tough to distinguish from normal tissue on the X-rays. About half of women under age 50 and about one-third of women over 50 have this density problem, and the younger they are, the more likely they are to have dense breasts. This gives premenopausal women a double whammy: They have no good early detection tool that's widely available and they have faster growing breast tumors, according to a study published last week.

News is looking worse and worse for the contraceptive patch made by Ortho Evra. Well-known consumer health advocate Sidney Wolfe petitioned the Food and Drug Administration yesterday to remove the patch from the market, saying that there's enough research to show that patch users have unacceptable higher risks of dangerous blood clots than those who take birth control pills. The FDA has already slapped a warning label on the patch that's been updated several times to reflect new studies finding that women who wear the patch have about double the risk of developing the clot condition called venous thromboembolism. That's most likely because the patch exposes them to 60 percent more estrogen than what they'd get if they were on a pill containing 35 micrograms of estrogen.

Wolfe wrote in his letter to the FDA that although "demand for the patch has dropped dramatically, from over 9.9 million prescriptions filled in 2004 to 2.7 million prescriptions filled in 2007," the patch is still among the top 200 brand-name drugs prescribed in the United States. I also previously blogged on a study showing that patch users were far more likely to be bothered by breast pain, nausea, and longer and more painful periods than those who used the vaginal ring, another kind of hormonal contraception. And Wolfe cites other research showing patch users are also more likely than pill users to have these side effects.

I write this column having just returned from an all-inclusive resort in Jamaica, where sipping piña coladas throughout the day is de rigueur. Part of my pleasure, though, was replaced by apprehension that I could be increasing my breast cancer risk with every drink, news that was reported in April at the American Association of Cancer Research annual meeting. Then again, I might be strengthening my bones. That's according to a review of 33 studies published in this month's American Journal of Medicine . Strong bones or breast cancer? I wondered as I sipped all those frothy rum-based concoctions. And what about those heart benefits associated with imbibing?

I posed these questions to JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital, since she has analyzed alcohol's various risks and benefits over the years as a researcher in the Nurses' Health Study of 120,000-plus women. "First of all," she informs me, "no one should begin drinking alcohol in order to reap health benefits, since it's very difficult to predict whether risks will outweigh benefits and vice versa." That being said, the results of the Nurses' Health Study and others suggest that women who drink moderately (a daily glass of wine, bottle of beer, or shot of tequila) live longer than those who don't; though they're more likely to die of breast cancer, they're less likely to die of heart disease, which kills more women every year.

I think I've written "heart disease is the No. 1 killer of women" in at least two dozen articles over the past decade. Yet many women still haven't gotten the message that heart attacks strike them as often as men—albeit usually a decade later. At an American Heart Association meeting held today, Yale researchers reported that women in their 40's and 50's who suffered heart attacks often delayed getting treatment because they didn't think they were having one. While it's true women under 60 make up only 5 percent of heart disease patients, the researchers point out that this translates into 16,000 deaths and 40,000 hospitalizations every year. Plus, more young women appear to be dying from heart disease, according to a British study published today, possibly because of increased rates of smoking, obesity, and diabetes.

Here's a list of heart attack warning signs in women from most common to least common, based on a previous study of young female heart attack patients conducted by the same researchers.