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.

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).