Black Women’s Maternal Deaths Go Unquestioned

Statistics showing that African-American women die at much higher rates in childbirth and pregnancy don’t surprise Dr. David R. Williams.

”This pattern is not unique to childbirth,” said Williams, a professor of African and African-American studies and of sociology at Harvard University in Cambridge, Mass. ”It affects the health of African Americans from cradle to grave and has continued for over 100 years. Today African Americans are more likely to die of 13 of the top 15 causes of death than are whites.”

While college-educated Black women who have well-paying jobs do have better health outcomes than poor unemployed black women who don’t finish high school, Williams says they still don’t do as well as their white counterparts because of the inequalities in society.

Despite federal anti-poverty programs, the civil rights movement and major advances in obstetrics, African-American women are three to four times more likely to die in childbirth than white women.

In 2005, 347 White women died compared to 245 black women, according to Dr. William M. Callaghan, acting chief of the maternal and infant health branch of the division of reproductive health at the Atlanta-based Centers for Disease Control and Prevention (CDC). But African American women’s far smaller share of the national female population means their death rates are four times higher, on average, than those of white women.

In places such as New York City, the risks are even greater–African American women die seven times more often than pregnant white women.

”Leveling the playing field for African American women in childbirth will require healing the health care system as well as the woman,” Williams said. ”Hospitals and health care providers must change their policies and practices.”

Lack of Data Stalls Change
Changing hospital policies and practices of health care practitioners is hampered by the lack of data.

The CDC estimates that 1,000 American women die of pregnancy-related complications each year, but the number may be even higher because there is no federal requirement to report maternal deaths.

”Only 30 states have formed maternal review committees, so it is difficult to draw conclusions based on the limited number of deaths in a particular state like New York or California,” said Dr. Jeffrey C. King, chair of the maternal mortality special interest group of the American College of Obstetricians and Gynecologists, the Washington-based professional organization of physicians with advanced training in women’s health.

”America must do better,” King added. ”Every maternal death needs to be investigated in the United States–as it is in Great Britain–so that changes can be made to improve the quality of care. While the total number of maternal deaths is small, it is worrisome because every woman who dies is a tragedy for her family and society.”

A recent report by the New York Academy of Medicine and the New York City Health Department found that African Americans–only 24 percent of city’s maternity wards–had the largest percentage of deaths in all four leading causes of maternal mortality: embolism, hemorrhage, infection and pregnancy-induced hypertension.

Compared to Whites, Blacks nationwide receive less income at the same level of education and have fewer assets at equivalent incomes that can be tapped to pay for quality health care. Black women also may have had limited income earlier in life, so that hypertension, heart disease and other conditions that can lead to childbirth-related death are not diagnosed or treated appropriately.

But some insurance data in the New York study cast doubt on the extent to which a woman’s personal finances can be specifically correlated to things going wrong in pregnancy and childbirth.

Toll of Discrimination
Discrimination over a lifetime and institutional racism take an immeasurable toll on women’s health. Recent studies have shown that prolonged stress may increase anyone’s risk for infection. Stress may also trigger the release of hormones that lead to premature labor.

America’s overall record on maternal mortality is poor. A 2010 report by the United Nations placed the United States 50th in the world for maternal mortality.

The U.N. data indicated that the vast majority of countries reduced maternal mortality ratios for a global decrease of 34 percent between 1990 and 2000, while the rate nearly doubled in the United States. America’s standing is alarming because the United States spends more on childbirth-related care than any other area of hospitalization–$86 billion a year.

Maternal mortality suffers from a poverty of interest.

The CDC estimates that quality maternal care could prevent 40 to 50 percent of maternal deaths and 30 to 40 percent of near-deaths and complications. But research to determine more effective practices has languished in the last 40 years because scientists and clinicians have focused on reducing infant deaths.

”At the beginning of the 20th century, the number of maternal deaths plummeted because we took a close look at why women were dying and came up with innovations in prenatal care and delivery,” said Dr. Franklyn H. Geary Jr., a professor and director of the division of maternal fetal medicine of obstetrics at Morehouse School of Medicine in Atlanta. ”Similar research is needed today because maternal mortality is a daunting problem, especially for African Americans.”

Head of Planned Parenthood Calls on Students to Fight for Women’s Health

In the wake of threats to federal funding for Planned Parenthood, President and CEO of Planned Parenthood of the Southern Finger Lakes Joe Sammons spoke to students on Wednesday about the future of the organization and the upcoming budget discussion.

Prefacing his discussion with the proposed cuts to Title X, a federal grant program that provides comprehensive family planning, Sammons described what he called the public’s misconceptions concerning Planned Parenthood’s primary activities and purposes.

Contrary to common belief, Sammons said, abortion does not make up the majority of Planned Parenthood’s services.

94 percent of Planned Parenthood’s services are preventative, such as providing contraception and cervical cancer screenings. Abortion makes up the remaining six percent, he said.

Sammons noted that the public, swayed by “well organized and well funded” campaigns, considers Planned Parenthood primarily to be a crusading voice for abortion. This association with the “loaded dirty word” serves as a “wedge issue” to withhold funding from the organization as a whole, according to Sammons.

Julie Spalding ’11, who attended the event, agreed with Sammons’ statement about the misconstrued purpose of P.P.

“The general population does not know that Planned Parenthood offers services other than those dealing with … abortion,” Spalding said. “Planned Parenthood is not just abortion, it is women’s health.”

Because Planned Parenthood does not use government funding for abortions, the organization’s stance on abortion should not apply to the recent government funding debate, Sammons said.

“I do not have the time to list every service that we use federal funds for, but I can tell you one that we do not: abortion,” Sammons said.

Moreover, Sammons added, most of the services for which Planned Parenthood does use government funding are preventative in nature or provide family planning assistance and work to decrease the overall number of abortions, Sammons said.

Sammons also said that, in the event that government funding is cut, Planned Parenthood of the Southern Finger Lakes may be unable to provide community programs, such as the local rape crisis hotline, which derives 80 percent of its funding from government sources.

“I cannot imagine how we could support [the rape crisis center] program if those funds went away,” Sammons said. “I cannot imagine what would happen to those assault victims if those funds went away.”

Sammons also discussed to discuss the importance of the sexual education that Planned Parenthood provides to a society that downplays sex as an issue.

“When we start talking about sex in this country, we distort, we exploit, we vilify, we mock. We do everything except talk about and inform people about sex,” Sammons said. “We need to go out to wherever there are young people, wherever there are teachers, wherever there are parents and have a real honest dialogue about sex and sexuality.”

Sammons said that the opposing option, abstinence-only education, does not provide the knowledge teens need to make informed sexual decisions.

“Abstinence on its own does not mean all that much,” Sammons said. “What young people do is they act — whether they have good information, bad information or no information at all.”

Discussing the decades-long fight for increased access to healthcare for women, Sammons expressed concern that advances made in previous eras are being revoked by government propositions to discontinue funding programs like Title X. As questions about government funding for sexual and reproductive health programs are raised, society is moving “backwards” concerning women’s health freedoms, Sammons said.

“You would think that the rights we earned in one generation are preserved for the next, but they are not,” Sammons said.

Sammons called upon activists in the audience to stand with Planned Parenthood and defend the rights of women to “compassionate” healthcare.

“This is not about money. This is about women’s health and giving women the freedom to make decisions about their lives,” Sammons said.

Sammons noted that the “change in the conversation” regarding Planned Parenthood’s government funding occurred mainly because of public support. Politicians respond to the people who vote for them, Sammons said.

“We did not let [the withholding of government funding from Planned Parenthood] happen. More specifically, you did not,” Sammons said. “Over 5,000 calls went in to the congressional offices in New York State alone. Your voices changed the conversation.”

Protect Yourself from a Wrong Diagnosis

In the quest to cure what ails you, doctors sometimes don’t consider the health differences between the sexes. That may lead to a wrong diagnosis. Here are 3 medical conditions often overlooked in women and tips on how to protect yourself. Plus, test your smarts with our women’s health quiz…

1. Heart Disease
Nausea, shortness of breath and sharp chest pain are common symptoms of cardiovascular disease. In women, though, they might be blamed on anxiety or heartburn.

Many physicians still assume women under 55 years old seldom have heart attacks, says Hardy Schwartz, M.D., medical director of non-invasive cardiology at the Sarasota Memorial Heart & Vascular Institute in Florida. That means women who show symptoms of heart disease are almost seven times more likely to be misdiagnosed than men.

“Part of the problem is that so little research has been done on women, although it’s getting better,” he says.

Why it’s hard to diagnose: “Health care for women has traditionally focused on screening for breast, ovarian, cervical and other cancers,” says Norma Keller, M.D., clinical chief of cardiology at Bellevue Hospital in New York. “But ironically, heart disease is the No. 1 killer of women over 45, killing 1,400 women every day.” That’s more deaths than all cancers combined.

Most heart attacks are caused by coronary artery disease, usually the result of arteriosclerosis. This buildup of plaque causes arteries to harden and narrow, which prevents the flow of blood and can result in a heart attack.

Women manifest different symptoms of heart disease than men, particularly if they’re suffering from coronary microvascular syndrome (CMS), reports the Journal of the American College of Cardiology. In women with this condition, plaque collects in small arteries of the heart, which can be overlooked in routine angiograms.

How to prevent misdiagnosis: Women who experience heart disease symptoms – pressure or burning in the chest, shortness of breath, irregular heartbeat, dizziness, sweating, fatigue and nausea – should ask their doctor about a nuclear stress test or stress echocardiogram, Schwartz says.

Also, just as they do for cancer, women should get screened for heart disease and be aware of their risk factors:

* Find out if your parents or grandparents suffered from heart disease.
* Monitor your blood pressure regularly, especially if high blood pressure runs in your family.
* Have your cholesterol measured annually, more often if it’s high.
* If you smoke, quit.
* If you’re obese, lose weight. Exercise 30-40 minutes at least four times per week.
* If you’re diabetic, take your insulin as instructed, eat a balanced diet low in sugar and engage in daily exercise, such as walking.

For more info, check out our Heart Disease Health Center.

2. Fibromyalgia
About 10 million Americans – mostly young women – suffer from fibromyalgia (FM). It’s often called an “invisible” illness or disability because symptoms may seem unrelated and conventional medical tests typically come back normal.

But fibromyalgia is a chronic condition marked by widespread pain, intense fatigue, heightened sensitivity and needle-like tingling of the skin, muscle aches and spasms, weakness in the limbs and nerve pain. People with FM may also have problems sleeping and deficits in short-term memory.

For more on fibromyalgia, click here.

Its cause is unknown, although some experts believe stress or genetics play a role. Pain may worsen because of increased stress, excessive physical exertion, lack of deep sleep, and changes in humidity and barometric pressure.

One theory suggests that decreased levels of serotonin, a neurotransmitter that regulates sleep patterns, mood, feelings of well-being, concentration and tolerance to pain, may be a factor.

Why it’s hard to diagnose: “Symptoms vary from person to person,” says Bart Price, M.D., who practices internal medicine in Florida. “They overlap with other diseases and there are no definitive blood tests for it.”

FM is diagnosed by eliminating other conditions, but that’s why patients often get a wrong diagnosis. Other disorders, such as chronic fatigue syndrome, depression, Lupus, Lyme disease and thyroid conditions, can produce similar symptoms.

It’s also relatively rare: Only about 2% of the population has been diagnosed with FM.

There’s no universally accepted cure for fibromyalgia, but prescription muscle relaxants and nonsteroidal anti-inflammatory drugs are recommended. Mild exercise and sleep may reduce pain and fatigue, some studies suggest. Heat applied to the painful areas also may help, as well as physical therapy, massage and acupuncture.

How to prevent misdiagnosis: Be persistent with your doctor, Price says. Ask questions about your symptoms, request blood tests to rule out other diseases and seek a second opinion from a rheumatologist if necessary.

If you suspect you have FM, here are 8 important questions to ask your doctor:

* Have you checked for fibromyalgia?
* What can I do to ease my symptoms?
* What medications can I take?
* What drugs, foods or activities should I avoid?
* What alternative therapies or stress management techniques might help me?
* Do you recommend counseling?
* How do I explain my condition to others?
* Are there clinical trials in which I can participate?

3. Thyroid Disease
Thyroid disease is one of the most often undiagnosed and misdiagnosed diseases. It may affect up to 27 million Americans, according to the American Association of Clinical Endocrinologists; more than 50% of them go undiagnosed.

In fact, 1 in 8 women will develop a thyroid condition in their lifetime.

The thyroid gland regulates the pace of the body’s metabolism through the production of hormones. Hypothyroidism (associated with a slow metabolism) occurs when the thyroid fails to produce hormones triiodothyronine (T3) and tetraiodothyronine (T4).

Symptoms of hypothyroidism include:

* Weight gain
* Facial puffiness
* Fatigue, depression
* Dry skin
* Brittle nails
* Hair loss
* Development of a goiter
* Hoarseness
* Increased sensitivity to cold
* Constipation, muscle pains
* Cramps heavy menstrual flow
* Slow heart rate or congestive heart failure

With hyperthyroidism (associated with an overactive metabolism) T3 and T4 are overproduced. It can be caused by Graves’ disease (an autoimmune defect) or inflammation of the thyroid.

Symptoms of hyperthyroidism include:

* Weight loss
* Hot flashes
* Nervousness
* Anxiety
* Fine or brittle hair
* Increased sensitivity to heat
* Rapid heart rate
* Difficulty sleeping
* Frequent bowel movements
* Muscular weakness and lighter menstrual flow
* Eyes bulge with Graves’ disease

Why it’s hard to diagnose: “The symptoms are non-specific and come on gradually,” says Joseph Rand, M.D., a board-certified endocrinologist. “The condition is typically genetic and there are no other identifying risk factors.”

Undiagnosed and untreated thyroid disorders can lead to elevated cholesterol levels, heart disease, high blood pressure and depression. A blood test determines diagnosis, and hormone replacements can be taken in the case of hypothyroidism, Rand says.

With hyperthyroidism, doctors typically prescribe drugs to block the overproduction of thyroid hormone, radioactive iodine to destroy overactive thyroid tissue or surgery to remove the gland.

Should hysterectomy mean the ovaries come out too?

(Reuters Health) – Women who are having a hysterectomy should consider also getting their ovaries removed, suggests a new study.

The report showed that women who had their ovaries taken out had lower rates of ovarian cancer and were not more likely to get heart disease or a hip fracture – which had been a worry in this group because of the quick drop in hormones that happens once the ovaries are gone.

That doesn’t mean that all women who are getting a hysterectomy before menopause should also have their ovaries out.

“I’ve always said to my own patients, this is a woman’s individual decision,” Dr. William Parker, a gynecologist affiliated with the University of California, Los Angeles, told Reuters Health.

“Ovarian cancer is a terrible disease, but an extremely rare disease,” said Parker, who was not involved in the current study. “I think it’s important (to consider the options), and I don’t think there’s a pat answer.”

Led by Dr. Vanessa Jacoby from the University of California, San Francisco, the researchers used data from the Women’s Health Initiative study to compare women who had their uterus and ovaries removed with those who just had their uterus taken out.

Hysterectomies are often performed in women who haven’t hit menopause but have heavy bleeding or are bothered by benign tumors growing in the uterus. More than half a million women have the surgery every year in the U.S.

The current study included more than 25,000 women age 50 to 79. Researchers followed the women for an average of 7 to 8 years to determine how many were diagnosed with ovarian cancer, heart disease, or a hip fracture.

Ovarian cancer was very rare in both groups of women — 1 in 300 women who only had a hysterectomy were diagnosed with the disease, compared to 1 in 5,000 women who had their ovaries removed with the hysterectomy.

The authors calculated that 323 women would have needed to have their ovaries removed to prevent each case of ovarian cancer.

Both groups of women were diagnosed with heart disease and hip fractures at similar rates, and about the same amount of women in both groups died during the study – 8 of every 1,000 women each year.

Those findings differ from a previous study, co-authored by Parker, which found that women who had their ovaries removed were more likely to be diagnosed with heart disease and die than women who didn’t.

Two reasons for the difference, researchers say, may be that Parker’s study followed women for a longer period of time and included women who were younger, on average, than the women in the current study.

That makes the studies difficult to compare, said Lauren Arnold of Washington University in St. Louis, who wrote an editorial accompanying the new research in Archives of Internal Medicine.

“It just underscores that there’s a lot that goes into the decision about whether to remove the ovaries,” Arnold told Reuters Health. “Sometimes the decision is fairly clear cut,” such as for women who have a gene that puts them at a high risk for ovarian cancer.

In that case, most doctors recommend women have their ovaries out because the survival rate for ovarian cancer is so low – most women aren’t diagnosed until the cancer is advanced, and then fewer than one in three will survive another 5 years, the researchers report.

“But if you don’t have an ovarian cancer risk, you have a lot of different factors to weigh,” Arnold said.

Parker said that women should also consider if they or anyone in their family has a history of heart disease – which his study suggested would mean that leaving in the ovaries is a good idea.

Jacoby said the question of whether or not to remove the ovaries can be based on a woman’s personal feelings about ovarian cancer, heart risks, and her own body.

“The main message that I hope women get is this is a very personal decision and they should really talk to their doctor about the risks and benefits of removing their ovaries,” Jacoby told Reuters Health. “There’s no right answer.”

Report: African-American Women at Higher Risk for Maternal Death in Calif.

In California, African-American women are dying of pregnancy related-causes at rates seen in some developing countries, and at four times the rate of white women and other ethnic groups in the state.

A new report from the California Department of Public Health reveals the stark disparity: the mortality rate for black women was 46 deaths for every 100,000 live births from 2006 to 2008, while the rates for Asian, white and Hispanic women in the same period ranged from 9 to 13 deaths per 100,000 births.

“African-American people generally have worse health outcomes than Caucasian people…but not to this degree, not four-fold,” said Conrad Chao, a clinical professor of obstetrics and gynecology at the University of California, San Francisco, who worked on the report. “What surprised me when we got through the numbers was the magnitude of the disparity.”

A 2007 Centers for Disease Control national breakdown showed a similar — but smaller– race gap, with black women at about three times the risk for maternal death as white women.

Taken as a community, African-American women in California have a maternal mortality risk comparable to rates in Kazakhstan and Syria, according to World Health Organization data.

The report was authored by a panel of experts investigating the rising rates of maternal death in the California over the last decade. Across the country, maternal mortality rates have increased from 8.5 in 100,000 live births in 1996 to 12.7 in 100,000 in 2007.

Experts have suggested a number of possible contributing factors, including improved data collecting and reporting, women delaying pregnancy to a later age, higher rates of preexisting health conditions such as hypertension, and higher rates of Caesarian deliveries.

Obesity is considered a major risk factor for pregnancy, since it can contribute to other health issues that cause complications. An in-depth look at 2002-2003 data in the report found that black women who died of maternal causes in California were more likely to be overweight or obese, and to have other medical risk factors.

The disparity data should be a wake-up call to other states, said Susan Wood, executive director of the Jacobs Institute of Women’s Health at George Washington University.

“This is not an isolated situation, California is a huge state. It shares many of the same health trends as other states, and this definitely raises critical issues,” she said, particularly for regions with high obesity rates. Southern states especially are known to have some of the largest health disparities and some of the worst health outcomes in the country. Access to prenatal services and outreach in California is also considered relatively strong among the states.

Chao emphasized it is unlikely that one factor is to blame for the rates, noting that the Hispanic population has seen a marked rise in obesity that has yet to be matched with a spike in maternal deaths.

Education level does appear to play a role. 11 percent of all births in California were to women without a high school diploma, but accounted for 31 percent of mothers who died from 2002-2003.

Michael Lu, an associate professor of obstetrics and gynecology at UCLA who was not involved in the analysis, studies race and socioeconomic disparities in maternal and infant health. He called the findings a landmark report, and a call to action across the country.

“The magnitude of this black-white gap in maternal mortality is the greatest among all health disparities…and that gap is growing,” Lu said. “It’s unacceptable.”

Lu pointed to two major factors that doctors have known impact maternal health for a long time, both the mother’s health status before pregnancy and the quality of health care she received during pregnancy at birth.

Chao said the analysis could not draw any concrete conclusions about quality of care, but that further exploration of the issue is a must. The committee determined that more than one-third of the maternal deaths had a good chance of being prevented, especially in cases of hemorrhage or infection.

Should hysterectomy mean the ovaries come out too?

The report showed that women who had their ovaries taken out had lower rates of ovarian cancer and were not more likely to get heart disease or a hip fracture – which had been a worry in this group because of the quick drop in hormones that happens once the ovaries are gone.

That doesn’t mean that all women who are getting a hysterectomy before menopause should also have their ovaries out.

“I’ve always said to my own patients, this is a woman’s individual decision,” Dr. William Parker, a gynecologist affiliated with the University of California, Los Angeles, told Reuters Health.

“Ovarian cancer is a terrible disease, but an extremely rare disease,” said Parker, who was not involved in the current study. “I think it’s important (to consider the options), and I don’t think there’s a pat answer.”

Led by Dr. Vanessa Jacoby from the University of California, San Francisco, the researchers used data from the Women’s Health Initiative study to compare women who had their uterus and ovaries removed with those who just had their uterus taken out.

Hysterectomies are often performed in women who haven’t hit menopause but have heavy bleeding or are bothered by benign tumors growing in the uterus. More than half a million women have the surgery every year in the U.S.

The current study included more than 25,000 women age 50 to 79. Researchers followed the women for an average of 7 to 8 years to determine how many were diagnosed with ovarian cancer, heart disease, or a hip fracture.

Ovarian cancer was very rare in both groups of women — 1 in 300 women who only had a hysterectomy were diagnosed with the disease, compared to 1 in 5,000 women who had their ovaries removed with the hysterectomy.

The authors calculated that 323 women would have needed to have their ovaries removed to prevent each case of ovarian cancer.

Both groups of women were diagnosed with heart disease and hip fractures at similar rates, and about the same amount of women in both groups died during the study – 8 of every 1,000 women each year.

Those findings differ from a previous study, co-authored by Parker, which found that women who had their ovaries removed were more likely to be diagnosed with heart disease and die than women who didn’t.

Two reasons for the difference, researchers say, may be that Parker’s study followed women for a longer period of time and included women who were younger, on average, than the women in the current study.

That makes the studies difficult to compare, said Lauren Arnold of Washington University in St. Louis, who wrote an editorial accompanying the new research in Archives of Internal Medicine.

“It just underscores that there’s a lot that goes into the decision about whether to remove the ovaries,” Arnold told Reuters Health. “Sometimes the decision is fairly clear cut,” such as for women who have a gene that puts them at a high risk for ovarian cancer.

In that case, most doctors recommend women have their ovaries out because the survival rate for ovarian cancer is so low – most women aren’t diagnosed until the cancer is advanced, and then fewer than one in three will survive another 5 years, the researchers report.

“But if you don’t have an ovarian cancer risk, you have a lot of different factors to weigh,” Arnold said.

Parker said that women should also consider if they or anyone in their family has a history of heart disease – which his study suggested would mean that leaving in the ovaries is a good idea.

Jacoby said the question of whether or not to remove the ovaries can be based on a woman’s personal feelings about ovarian cancer, heart risks, and her own body.

“The main message that I hope women get is this is a very personal decision and they should really talk to their doctor about the risks and benefits of removing their ovaries,” Jacoby told Reuters Health. “There’s no right answer.”

Women’s health at risk this legislative session

Did you know that 97 percent of Planned Parenthood’s work is for preventive services that help women, families and communities stay healthy? If you answered “no,” you may be relying on a few state legislators for your information.

During a Health and Human Services committee hearing last week, Rep. Ron Renuart, R-Ponte Vedra Beach, misstated that almost 37 percent of the total income of Planned Parenthood is from abortions and suggested that our organization opposes anti-choice bills because “they don’t want to lose business.”

Rep. Liz Porter, R-Lake City, during closing remarks on a bill to mandate an ultrasound prior to abortion, also misstated that “the real objections of organizations like Planned Parenthood [to this bill]… is fear of the effect to their bottom line.”

Earlier this month, a member of Congress cited inaccurate statistics about the services Planned Parenthood provides and was lampooned in the press.

The people who are charged with passing laws — including public health policies — seem to be basing their decisions on fiction or outright lies. The fact is that Planned Parenthood is a trusted provider of affordable, quality reproductive health-care services. Yes, it does provide abortions, which account for 3 percent of its services. The other 97 percent of its work is preventive, including life-saving cancer screenings, breast health care, wellness exams, contraceptive services, and prevention and treatment of sexually transmitted infections and diseases.

Planned Parenthood works hard to give women access to the reproductive health services that they need to stay healthy — and to avoid unintended pregnancies. Too many of our legislators are more interested in promoting their extreme anti-choice agenda than they are in the truth or in helping women avoid unintended pregnancies.

Two years ago the Centers for Disease Control and Prevention [CDC] reported studies that showed women in Florida have the least access to reversible contraception, such as the pill, than women in all the rest of the country. Contraceptive use prevents abortions.

During these hard economic times, when Florida families are struggling and the number of uninsured is rising, more women are turning to community health providers like Planned Parenthood for trusted, high-quality affordable health care.

But in this current session of our Legislature, 18 bills that attack women’s health and rights have been introduced. From a mandatory-ultrasound bill — which would force women to undergo an unnecessary and expensive medical procedure before they could get an abortion — to a full ban on abortion, the impact of these bills, if passed into law, would be devastating. Women’s rights would be set back decades. Women’s health would be at risk.

The Florida bills are among the most extreme in the nation — many lack exemptions for women who are facing threats to their health or coping with fetal impairment or rape or incest. What is missing from all of these proposals is an understanding of the complicated and unique circumstances women face when deciding to terminate a pregnancy. As legislators consider these bills, they would do well to examine the facts — not rhetoric and lies.

Our legislators owe it to their constituents to debate these anti-choice bills honestly. Instead, our Legislature has become fodder for late-night comics by censoring the word “uterus” and refusing to proclaim “Birth Control Matters” day — all the while turning their backs on measures that would reduce the number of unintended pregnancies in our state.

Florida needs community health providers like Planned Parenthood for first-rate health care and as an organization willing to fight for women’s reproductive health and rights. Especially during these tough economic times, when Floridians face high unemployment rates and many do not have health insurance, good, economical health care is vital.

Our legislators should stop attacking Planned Parenthood and, instead, join them. We all want to reduce the number of abortions in our state, and family planning and sound, economical health care for women are the paths to follow.

Dr. Bill Elliott: Calcium supplements may harm heart

COULD YOUR CALCIUM supplements be harmful to your heart? The answer may be yes based on new evidence from the Women’s Health Initiative (WHI) study. This surprising finding is the result of some diligent work by a group of researchers from New Zealand who took a new look at the WHI, the huge research study that has looked at the health of more than 160,000 women from 1991 until the present.

Calcium supplementation is one of the most commonly recommended “healthy lifestyle” interventions, especially for women over the age of 50. There is evidence that calcium plus vitamin D improves bone health, and up until now calcium has been considered relatively safe with the only major side effect being an increased risk of kidney stones.

Calcium supplementation has been particularly popular since 2002 when the first link between hormone replacement therapy and breast cancer became known. Prior to that, hormone supplementation was the primary weapon against bone loss for postmenopausal women. Ironically the hormone/cancer link was the first major finding of WHI.

Calcium, however, may not be as safe as we once thought. Last year, researchers from New Zealand published a study that suggested that calcium supplementation may be associated with an increased risk of cardiovascular disease, stroke and heart attack.

The speculation was that rapid increases in calcium levels caused by taking calcium pills might make the blood more sticky and contribute to hardening of the arteries. The concern was only with calcium pills — not dietary calcium.

Increasing dietary calcium causes gradual increases in calcium that is not believed to be harmful to arteries. The New Zealand researchers got their data from a number of small studies and although their conclusions were interesting, their research paper did not garner much attention, especially in this country.

To further test their thesis about the risk of calcium, the New Zealand researchers decided to reanalyze data from WHI. It seemed a strange place to look since WHI had specifically looked at the issue of calcium supplementation and had not found a relationship to cardiovascular disease.

There was one important caveat, however, that was overlooked in the original publication — many of the women who enrolled in WHI were already taking calcium when they started the study. The New Zealand group looked specifically for women who had not been taking calcium when they enrolled in WHI. Of the 17,000 women who met this criteria, some were started on calcium pills as part of the study and the others remained on no calcium. It was this group that was evaluated in this new research study.

The results were published online last week in the British medical journal BMJ. The researchers found that women who started calcium supplementation had a small, but statistically significant increase in the risk of cardiovascular disease especially heart attack. The risk was only associated with calcium supplementation and not with vitamin D supplementation.

Their conclusions were: “Calcium supplements with or without vitamin D modestly increase the risk of cardiovascular events, especially myocardial infarction (heart attack), a finding obscured in the WHI CaD Study by the widespread use of personal calcium supplements. A reassessment of the role of calcium supplements in osteoporosis management is warranted.”

These findings bring up a couple of important questions for older women and their doctors: Does the risk of taking calcium out weigh the benefit? And if women are already taking calcium should they stop?

Most experts believe that women need extra calcium to maintain healthy bones. There is also good evidence that adequate vitamin D levels are essential for good bone health. Weightbearing exercise stresses the bones and makes them stronger; walking, running and resistance exercises all are beneficial.

But calcium supplementation? This is an issue that will need more research.

Everyone can agree that a diet high in calcium is important and beneficial. If a woman is able to calculate the amount of calcium in the diet, and she is able to consume at least 1,200 mg a day, then there is no need for supplementation. On the other hand, if she is not able to take in adequate dietary calcium and is at low risk for heart disease, then taking a supplement may be beneficial.

If a woman is at high risk for heart disease, however, the question becomes more complicated. Women with known heart disease, hypertension, diabetes or high cholesterol may want to discuss this issue with their doctor before starting calcium supplements.

This discussion centers almost entirely on women because they at are much higher risk of osteoporosis and fractures than men. Most men do not need calcium supplementation, and based on this recent study, men should not be routinely taking calcium unless there is a specific medical need.

Event will focus on making women’s health a priority

Female employees of local government and colleges will be able to attend an event Thursday called “Nourishing Body and Mind” at the Bismarck Civic Center.

Women, who are often caregivers for others in their lives, may forget to focus on their own health, said Wanda Agnew, director of nutrition services for Bismarck Burleigh Public Health.

This event will offer mini-workshops on health topics as well as a keynote speaker, Barb Marchello, who will discuss local foods and North Dakota food traditions.

Female employees of the city of Bismarck, Burleigh County, the Bismarck Park District, the University of Mary, United Tribes Technical College, Rasmussen College and Bismarck State College who attend will be encouraged to make personal health and wellness a priority, Agnew said.

Doors open at 4 p.m. and the event begins at 5 p.m. in the Civic Center’s Upper Level Exhibit Hall, Prairie Rose Rooms.

Marchello will give her keynote address at 5:15 p.m.

The mini-workshops will include information on whole grain flour, outdoor activities offered by North Dakota Game and Fish department, sleep concerns and money management. More than 40 vendor booths also will be available.

Among other concerns, women attending will hear about the importance of several steps to incorporate into their daily lives, including:

- Getting at least 2 1/2 hours of moderate physical activity, or 1 hour 15 minutes of vigorous physical activity, or a combination of the two, each week.

- Eating a nutritious diet.

- Visiting a health care professional for regular checkups and preventative screenings.

- Avoiding risky behaviors such as smoking and not wearing a seatbelt.

- Paying attention to mental health, including getting enough sleep and and managing stress.

The U.S. Department of Health and Human Services Offices-Women’s Health supports these women’s health events.

Women’s Health a Priority for LLUMC

Loma Linda University Medical Center is taking several steps to educate women in the community on all the hospital has to offer – both at their physical location and online.

“Women are the major health care providers for their families, and they need to take care of themselves,” said Beverly Rigsby, service line development director, GYN, women’s urology, ENT, and robotic and minimally invasive services. “I am a mother of three girls, and I find it difficult to make time for myself. We make it as simple and easy and in one place as we can.”

There’s no typical female patient that walks through the doors of LLUMC.

“It depends on their age,” said Rigsby. “For younger women, it’s mostly for their yearly GYN appointment, and if they’re pregnant, it’s for OB. Once they hit 45, they go to imaging, and hopefully they never hit cancer. Around 40 to 45, other services that we start using are incontinence for those with difficulty after childbirth, mammograms, and hysterectomy surgery. We do have more female patients, largely because of labor and delivery, but also because women use the health care system more than men.”

Female specific offerings at the LLUMC include female pelvic medicine and reconstructive surgery; women’s imaging; robotic and minimally invasive surgery center; and OB/GYN. Breast ultrasounds, mammograms, robotic or laproscopic surgery, infertility services and women’s heart services are just some of the services.

“With our robotic and minimally invasive surgery center, it causes much less bleeding, less time in hospital, and is much easier on the patient,” Rigsby said. “Usually they can be back to work in a week or two.”

OB brings in women with on-track pregnancies as well as high risk.

“We have high risk OB, so if there’s something wrong or they worry about it, if the mom is high risk, we get all the referrals in the region,” Rigsby said. “We have a fairly large NICU, if they’re worried about the baby being delivered.”

Online, the women’s health website answers common women’s health questions, and has links to specific hospital departments and services, like urogynecology and female pelvic health. Rigsby started the online women’s center in 2006.

“We had a website company that helped us with the structure of it and the outline of it, and I ended up doing a lot of the specific information for each area that pertained to what I was working on,” Rigsby said. “Cancer for example goes to the cancer website after the initial introduction, and the same for heart.”

To promote women’s health even further, LLUMC hosts a women’s health event every November, which features educational sessions, free giveaways and lunch.

“It started three years ago with the marketing department,” Rigsby said. “750 attended last year, and it’s part of our community outreach. Women can come and learn more about their health, and we have keynote speakers. They can learn about how to deal with stress in their life during breakout sessions, as well as about women’s heart conditions, diabetes, weight loss, plastic surgery and incontinence.”

The hospital continues to expand, with LLUMC welcoming new staff members this spring, including a female doctor in the female pelvic medicine reconstructive surgery department.

“That’s big because a lot of women like to go to females,” Rigsby said.

Also coming aboard is a new infertility physician, and soon OB/GYNs will be hired to the growing robotic and minimally invasive surgery department.

“We’ve just hired a new department chair for OB, and he is a gynecologic oncologist,” Rigsby said. “He operates on cancer of the pelvis, uterine, all of those cancers. He is robotic minimally invasive trained, and looking at growing that area by hiring two or three more people to do just minimally invasive surgery for cancer in women.”

While LLUMC doesn’t have a women’s center with everything in one spot, they are working towards that, as well as continuing to get the word out about women’s health.

“I think the website was a start,” Rigsby said. “We’ve been doing seminars in the community, and would like to do more of those. There’s more information we want to get out there.”

When Will Black Women’s Health Matter?

When will Black women’s health matter? That’s a question I’ve asked myself more than once during the recent Congressional effort to repeal health care reform that would deny countless women of color access to affordable and quality reproductive health care services.

I asked myself that question again when I heard the story of a desperate Black woman in Sacramento who had saved to pay for her abortion but did not have enough money to pay for a babysitter for her two children (and barely enough gas money to drive the 60 miles to her appointment). She arrived at the clinic with her children in tow.

But it wasn’t until a group called The Radiance Foundation started putting up billboards saying abortion is Black genocide that the subject of Black women’s role in this debate made headline news. More controversy was stirred up recently when a group distributed flyers on Princeton University’s campus declaring, “In the new Klan, lynching is for amateurs,” and pointing to a website called klanparentood.com. I suppose I should be grateful for all this attention. However, given the willful deception and bizarre claims being spread by these campaigns (and lampooned on The Daily Show), I can’t say that I am.

The billboards had been appearing in Black communities coast to coast for more than a year, and the campaign was reported on months ago by the Times and other major news outlets. But when a huge ad went on display in lower Manhattan in late February, a real furor erupted, resulting in headlines across the U.S and even overseas.

The billboard, depicting a sweet, worried-looking young Black girl, declared: “The Most Dangerous Place for an African American Is in the Womb.” An accompanying Web site, toomanyaborted.com, informed visitors that abortion is part of a racist scheme “to stealthily target blacks for extermination.” Late last month, the same group unveiled billboards in Chicago with President Obama’s image and the tag line, “Every 21 minutes, our next possible leader is aborted.”

The new “Klan” website advertised on Princeton’s campus, obviously targeted to young people, is no doubt eager to stir similar outrage with its cartoon character of a doctor in a Klan hood wielding a knife, and its faux-hipster declaration, “We are the hood in parenthood.”
Viagra in Australia
Creating a perfect storm of race, class, and gender-baiting in the midst of the abortion and health care debate, these ads imply that Black women are either ignorant dupes of racist, profiteering abortion providers, or uncaring enemies of their people, willing to make Black children an “endangered species” to further their own selfish goals. By that same logic, the groups behind the billboards and web campaigns ought to take out ads against education, since studies demonstrate that well-educated Black women have fewer children.

So who are these groups that purport to care so much about the survival of the Black “species?” According to news reports, funding for the Radiance Foundation ads comes from Georgia Right to Life and the Georgia Republican Party, two largely white, male, conservative groups not previously known for their commitment to women or people of color. These are the same Republicans, after all, who recently passed a bill that would take away women’s access to critical services including prenatal health care, nutritional programs for infants, and child care assistance. Given all these cutbacks in services for one of the most under-served groups in America, a more accurate billboard would have said that the most dangerous place for an African American child is outside the womb.

But accuracy is not the point of these ads. Take for instance the claim that abortion is making black children an endangered species. While it is true that abortion rates for black women are higher in some states (including Georgia, where this campaign was hatched), it is also true that the fertility rate — or births per 1,000 women of childbearing age — among Black women remains higher than the national average and has inched up in recent years, according to data from the Centers for Disease Control. To the extent that Black women are having abortions in greater numbers, the Guttmacher Institute has determined that this is due to their greater incidence of unintended pregnancies, resulting from economic inequality and poor access to contraception and education.

All of which leads me back to my question: When will Black women’s health matter? In a country where Black women are likely to have less access to health care, have higher incidence of chronic illness and injury, and in which at least 17 percent are uninsured, it is little wonder that some are driven to abortion out of desperation. They are trying to keep body and soul together and save the children they already have. For women like that single mother of two in Sacramento, this is not a “choice” issue so much as a life circumstance — or a decision borne of desperate circumstances.

Perhaps Black women’s health care will begin to matter when politicians realize that protecting their health, improving their life circumstances and safeguarding personal decision making – not blaming them for genocide — is the route to making abortion less necessary. Billboards, lurid websites and punitive legislation will never accomplish this urgent goal, if indeed they were ever really meant to.

Making sense of scary news about calcium supplements

If you take a calcium supplement, you might be wondering what to make of a new finding from the British Medical Journal suggesting that calcium supplements increase a woman’s risk of heart attack and stroke by about 20 percent. Should you keep taking your supplement, and how do the benefits compare against the risks?

That’s a tricky question, and one that you might assume researchers have figured out by now — given that Americans with thinning bones have been advised to take the bone-protecting supplement for decades. Turns out, though, that calcium might be yet another nutrient that’s been oversold as a supplement — at least according to some experts.

“I think all people taking calcium supplements should reassess whether these are doing them any good,” says study co-author Dr. Ian Reid, a professor of medicine and epidemiology at the University of Auckland in New Zealand via email. “Our paper shows that for every three fractures that are prevented by calcium, six heart attacks or strokes are caused. Thus, the balance of risks and benefits is negative.”

That finding, though, only applies to healthy postmenopausal women who were randomly assigned to take calcium along with vitamin D; more than half the women participating in the clinical trial — the landmark Women’s Health Initiative — were already taking calcium supplements on their own to, say, combat thinning bones. Oddly, those who were randomly assigned to take even more calcium had no increased heart or stroke risks compared to those who were assigned to take a placebo.

In fact, the supplement takers who were given more calcium had about a 16 percent lower risk of dying compared to their counterparts who took placebos.

Confused yet? So are experts who aren’t sure what to make of the findings and whether they mean that some benefit from calcium supplements more than others. Also, men weren’t included in the study, which means they could have a different risk-benefit profile.

“It is not possible to provide reassurance that calcium supplements given with vitamin D do not cause adverse cardiovascular events or to link them with certainty to increased cardiovascular risk,” write the European authors of an editorial that accompanied the study. “Clearly further studies are needed.”

Until then, experts say we need to exercise some common sense when it comes to calcium. “I think it’s generally a good idea to get as much calcium as you can from food rather than supplements,” says Dr. Frank Hu, a calcium researcher and professor of nutrition at Harvard School of Public Health.

Women aged 51 and over and men aged 71 and over need 1,200 milligrams a day of calcium. Younger adults need 1,000 mg a day. Eight ounces of yogurt, an eight-ounce glass of milk, and a 1.5-ounce serving of cheddar cheese provide 1,000 mg of calcium. Adding a cup of fortified orange juice can get you up to 1,200 mg.

Experts generally agree that there’s no benefit to exceeding the government’s daily recommended allowance and that we should aim to get no more than 800 mg of daily calcium from a supplement. Research indicates that calcium overdose has become more common in recent years leading to an increased risk of high blood pressure and even kidney failure.

If you do have thinning bones, talk to your doctor about the pro’s and con’s of calcium supplements. They only have a modest effect on fracture prevention, says Hu, and need to be taken along with vitamin D.

Protect women’s health-care access

The question of Planned Parenthood’s government funding is so divisive that it almost shut down the federal government this month before a last-minute compromise. Now, the issue is splitting Hoosiers after the legislature moved closer to making Indiana the first state to ban the agency from receiving Medicaid funds.

The state Senate voted on Tuesday to cut off all tax dollars going to Planned Parenthood of Indiana, a proposal that had died earlier in the House.

Opponents of defunding argue that Planned Parenthood, barred from using tax money for abortions, puts the funds into family-planning and other health services that aren’t widely available elsewhere, especially for the poor and uninsured. They also say these services can reduce abortions, that simply removing government funding won’t decrease the number of abortions, and that Indiana will ring up a $68 million Medicaid bill for unintended pregnancies if the measure passes.

Still, as a private organization, Planned Parenthood doesn’t have a special right to public funding. The fact that it performed 5,500 abortions in Indiana last year can’t be ignored.

The key question is whether all women in Indiana would have access to health care such as cancer screenings, protection against sexually transmitted disease and birth control if Planned Parenthood is denied tax dollars.

The answer, for now, is uncertain. In some areas of the state, particularly in Southern Indiana, women have few alternatives to Planned Parenthood for reproductive health services unrelated to abortion.

It’s true that some clinics that don’t perform abortions hope to expand. A clinic called Open Door Health Services, for example, plans to double its patient capacity within three years.

But what will women do in the interim if Planned Parenthood cuts its services or closes clinics because of the loss of public dollars? And what happens if alternative clinics, despite their best intentions, aren’t able to raise the money needed to greatly expand their capacity?

Abortion opponents shouldn’t let their disdain for Planned Parenthood lead them to make decisions that ultimately could hurt women, including many who have no intention of having an abortion.

In an ideal world, all women, regardless of where they live in the state, would have sound alternatives to Planned Parenthood. But, as abortion opponents know all too well, the world, as it now exists, is far from ideal.

Mercer Islander is leader of women’s health studies

Islander and epidemiologist, Dr. Andrea LaCroix is again at the center of the decades-long discussion about the efficacy and risks of hormone replacement therapy for menopausal women. The results of the recent phase of the studies she has lead indicates some significant benefits for women who took estrogen alone beginning in their 50s after hysterectomies.

From the paper in the Journal of the American Medical Association to lengthy stories in the New York Times and the McNeil Leher Report, LaCroix has been questioned and quoted about what these new results mean. The findings will most certainly add to discussions between women and their doctors about other risks of medication to ease the symptoms that can occur with menopause.

LaCroix is a professor of epidemiology at the University of Washington, where she works at Fred Hutchinson Cancer Research Center. She is the lead investigator tracking the health of thousands of women who were participants in an unprecedented study of hormone use begun in 1991. The studies, which looked at the effects and risk of hormone medication on menopausal women, were conducted through the Women’s Heath Initiative (WHI) study funded by the National Institutes of Health (NIH). Millions of women contemplate taking hormones each year.

Data from the U.S. Census suggests that women between the ages of 45 and 55, represent the single largest segment of the U.S. population.

The Reporter first wrote about LaCroix and her work on the WHI studies in 2002.

LaCroix is the lead author of the findings published in the April 6, 2011, issue of the Journal of the American Medical Association. The news headlined national media outlets and was reported and parsed by journalists, readers and doctors everywhere.

The findings of the study represent a reversal of sorts from the news of 2002 and 2004, when the NIH sounded a cautionary alarm about what they perceived was an unacceptable risk to participants of hormone replacement therapy. NIH stopped the study on the combination of hormones in 2002, and the estrogen-alone study in 2004.

But researchers continued to follow the women to find out what effect the hormone use — taken even for just a short period of time — might have on the health of the participants in the long term. Their health was followed and compared to those who did not take the drug.

The study yielded a surprising result. The hormone-taking women who had hysterectomies, who used estrogen alone, showed a 23 percent lower risk of invasive breast cancer than their counterparts who were taking no hormones at all.

“The data seemed to ‘speak clearly,’” LaCroix said for benefits lasting well after the drug had been stopped.

“In their 50s, women can be very reassured that, if they decide to take hormone therapy for relief of menopause symptoms or for other reasons, that they’re not going to have an increased risk of breast cancer; they’re not going to have more heart attacks. In fact, their risks of those outcomes might be lower.”

LaCroix said there are other important findings.

Risks and benefits of hormone therapy differ importantly by age for several types of chronic disease: heart attacks, colorectal cancer, death. Overall, chronic diseases are lower among women taking the single hormone therapy in their 50s compared to placebo, but among women in their 70s, they actually had higher rates of all these conditions if they were taking estrogen alone vs. placebo.

There are some caveats, to be sure. Every patient is different. The study was not designed to measure the effect of when or how long to take the drug.

Despite these encouraging results for this particular set of women, LaCroix emphasizes that the results — both positive and negative — are useful for all.

These studies are about health and about informing women, she said. “It is not clear what each individual should do,” she said.

LaCroix holds a master of science in public health nursing and a Ph.D. in epidemiology, the study of the causes of disease, from the University of North Carolina in Chapel Hill, N.C., in 1984. She spent many years in Washington, D.C., where she earned her first nursing degree at Georgetown University. She later returned there to post doctoral studies at Johns Hopkins University and the National Institutes of Health.

Islanders since 1989, LaCroix and her husband, Fred LaCroix, have two seniors at Mercer Island High School. The twins are in the high school marching band that performed in the New Year’s Day parade in London in January.

“Each arrived in the city via different flights,” their mother said, noting that she and her husband got up in the middle of the night to watch them march on television. They are heading off to college next fall. She said it is going to be very different with both gone at the same time.

Of the media attention, LaCroix said that it has been “a privilege to interact with the media,” noting “they are bright and informed.”

“I am here to help people to understand what all of this means,” she explained. “I have had all sorts of good conversations. Hopefully, it will help encourage more introspection about how we view these types of therapies.”

Learn more

For more information on the results of this and other WHI studies and resources, go to www.whi.org.

LaCroix is also part of a study called ‘MsFlash’ sponsored by Group Health Research Institute. Seattle is one of five locations in the United States conducting the study. Islanders received a flyer about the study in the mail earlier this month.

The study needs participants, ages 40 to 62, to study how yoga, exercise or taking Omega-3 fatty acids might ease hot flashes. The 16-week study will involve either yoga classes or exercise, the supplement or placebo.

Doctors: Too early for verdict on estrogen benefit

Women’s health experts at Northwest Hospital are taking a close look at a study released recently challenging long-held views on the benefits and risks of hormone replacement therapy, while trying to diffuse confusion for doctors and patients.

The study, released earlier this month in the Journal of the American Medical Association, details a survey of more than 10,000 women who had had a hysterectomy and who took estrogen-only hormone therapy for about six years.

The women, part of the National Institutes of Health Women’s Health Initiative study, were followed for about 11 years.

The study results seem counter to earlier findings that hormone replacement therapy raises the risk of breast cancer, stroke and heart disease, but doctors point out that the new study looked at a type of therapy that had not been studied closely before.

Traditionally, hormone replacement therapy was given to women who are in menopause or had it artificially triggered by a hysterectomy.

A combination of estrogen and progestin was standard therapy for women complaining of menopausal symptoms, such as hot flashes, mood swings and others. The progestin acts to protect the uterus from potential harmful effects of estrogen.

That therapy, although still in use, came under fire in 2002 when a Women’s Health Initiative study showed the hormone combination caused increased risk for breast cancer, heart attack, stroke, and blood clots. Since then doctors have been cautioned to prescribe only the lowest doses for the shortest amount of time to help relieve symptoms.

But the women in the study, who had had hysterectomies, did not need the progestin so they received estrogen-only therapy. It is specifically this group of women from which the surprising results were taken.

The study found that women who had had hysterectomies and received the estrogen-only therapy for about six years had a 23 percent lower incidence of breast cancer, compared to the women who took a placebo.

In addition, women in their 50s in the study on the estrogen-only therapy had lower incidences of heart attack and stroke.

“On its face it seems like a reversal,” said Dawn Leonard, medical director of the breast care center at Northwest Hospital. “But with the initial Women’s Health Initiative study, they really looked at combined [estrogen and progestin] therapy.”

While Leonard is hopeful about what the new findings may mean for breast cancer research and treatment she said it is too early make unequivocal decisions about using estrogen-only therapy to help reduce breast cancer, or heart disease and stroke.

“So much data needs to be found out,” she said.

For instance, Leonard said, “Would things be different if it was women taking estrogen for 10 years? Is there potential benefit for all risk factors?”

Risk factors include women with an elevated risk of breast cancer due to family history, a genetic predisposition, or women who have had several breast biopsies.

And although Leonard acknowledged that the new information might change the way hormone replacement therapy is perceived, or change breast cancer treatment, she said some information in the JAMA article was confusing, even for doctors.

“It said that taking estrogen reduces risk by 23 percent, but what if your risk is low to begin with?” she asked.

Leonard said the way hormone replacement therapy is prescribed has changed since the warnings about the combination therapy emerged.

“Historically, women were offered HRT if they had one hot flash,” she said, adding that it was accepted that it “prevented heart disease and stroke, keeps your brain working well, and keeps you youthful and young. But it had side effects.”

Leonard said there is more attention paid now to “symptom management.”

“Do we need to continue estrogen therapy if a patient is not having symptoms?” she said. “There is a risk to taking any medication.”

She said medications should only be prescribed for intractable symptoms, and a risk assessment should be done before taking any medication, including estrogen therapy, and that should be made on a case-by-case basis.

“Take it seriously,” Leonard said. “There’s no such thing as a risk-free medication.”

“Our grandmothers survived menopause without HRT,” she added. “We have to help patients manage symptoms with natural means and healthy means. Let’s exhaust the safest options first.”

Dee-Dee Shiller, director of the Women’s Wellness Center at Northwest, admitted being surprised by the study findings.

“I was not expecting a reduction in risk in the estrogen-only area,” she said. “After the Women’s Health Initiative Study [that showed risk from combined therapy] people had fears and went cold turkey.”

Shiller said she was most interested the findings on women in their 50s.

“In younger women there were less risks for heart disease – that was the most interesting part for me,” she said.

The study showed risk for heart disease and stroke increasing for women in their 70s.

And although she, like Leonard, sees the study as a hopeful sign for new treatments, Shiller said hormone replacement therapy should still be approached with caution.

“If we don’t know the risk factors – then it should be the lowest dose for the shortest amount of time,” she said. “But if you’re in your 50s and on HRT for less than seven years – that’s probably OK.”

She said one part of the study that raised questions for her was the type of estrogen used. Would, for instance, results be different if women were given estrogen that is more like human estrogen? The women in the study were given estrogen extracted from pregnant mare urine.

“Do these things completely change the results?” Shiller asked.

Shiller said the study of estrogen/progestin hormone replacement therapy that showed higher risk for breast cancer, heart attack and stroke, made many women fearful of trying the therapy. She said this estrogen-only study, although raising questions, may dispel some of that fear.

“Instead of everybody living in fear, it’s not horrible,” she said. “But I’m not going to change practices because of this one area.”

“The interesting part is that if you had a hysterectomy and removal of your ovaries when you were young, it may not be so risky to be on estrogen a while, until you’re older,” she added.

Silverton Hospital Network to host women’s health seminar

The Silverton Hospital Network will host a free event aimed at women’s health April 26 at 5:30 p.m. at the Silverton Hospital Family Birth Center.

Take Charge of Your Health will focus on raising awareness and providing education pertaining to women’s health issues and will also focus on prevention of potential problems.

Topics will include sexual, urological and bone health issues as well as breast cancer, found to be the No. 1 health concern among women according to recent surveys.

“The idea is to give women a lot of good information so that they will be able to make good health choices for themselves,” said Diane Dobbes, event coordinator. “These are issues that most women over 40 will face at some point in their lives.”

The conference will also include a 45 minute discussion on women’s health issues with surgeon James Nealon, M.D., urologist Michael Lemmers, M.D., radiologist Piper Rooke, M.D. and on-gyn Barbara Keller, M.D., all Silverton Hospital Network physician specialists.

Discussion topics will include breast cancer detection and surgery and problems brought on by menopause.

A demonstration called Standing Tall will take place along with a discussion on exercises meant to improve bone health and how to prevent the onset of osteoporosis.

Special door prizes and giveaways including an overnight getaway and spa package to the Oregon Garden Resort will be handed out.

The event will also feature food and interactive demonstrations, therapeutic massage sessions, a mini clothing boutique and a personalized health review.

“We want to empower women to take control of their lives and their health,” Dobbes said. “And the best way to do that is knowledge.”

Whole Family Health Launches New Website

Whole Family Health announced today the launch of its new website. The new Whole Family Health website provides Canadian families with information and resources relating to a range of health issues, including women’s health, men’s health, pediatric health, fertility, and pregnancy.

The new site also provides information on alternative health treatments such as acupuncture, Chinese herbal medicine, massage therapy, and mind body medicine.

“With the site, our aim is to offer a resource that will help families across Canada live healthier lives,” said Cecil Horwitz, owner of Whole Family Health. “We’ll be updating our blog frequently with articles written by our team of practitioners and other experts, so it will be a useful, practical source for information on health that people can keep coming back to.”

Information and articles on women’s health are featured, focusing on the various stages of life – from PMS, acne, and irregular menstrual cycles to fertility, pregnancy and menopause. Recent articles discuss the use of acupuncture in dealing with postpartum depression, ways to feel great during pregnancy, and using Chinese herbs to treat menstrual cramps.

On the subject of men’s health, visitors to the site can read about men’s fertility health as well as a variety of other men’s health issues including chronic pain, stress, headaches, back pain, frequent urination, and low libido. Recent articles discuss how the right diet can combat chronic back pain and how to reduce stress in daily life.

The Whole Family Health website also offers practical information on common pediatric health issues such as infant teething, asthma, and allergies. Parents will find articles on natural treatments for these ailments as well as for other common health problems such as earaches, rashes, colic, fever, and infection.

“In our experience, people are curious about the benefits of natural and alternative treatments and how they can be used to complement Western approaches to medicine and health,” said Horwitz. “We’re excited about this new opportunity to share our experience and expertise with the community.”

Whole Family Health
Whole Family Health is a health clinic located in Edmonton, Alberta, Canada. The clinic provides a range of health services, including acupuncture, massage therapy, Chinese herbal medicine, nutrition, and mind body medicine. Some of the health issues that practitioners at the clinic specialize in treating are chronic pain, stress, infertility, and pregnancy health.

Nearly 41,500 more women having breast screening

Associate Minister of Health, Hon Tariana Turia, reports that new figures show nearly 41,500 more women aged 50 to 69 have taken part in the Government’s free breast cancer screening programme in the 24 months to December 2010 than in the previous period.

“This increase is great news for women’s health. Not only are these women giving themselves the best chance for breast cancer to be found and treated early, but this is a sign women are prioritising their health” said the Associate Minister.

“The percentage of Maori and Pasifika women having breast screening has had the greatest increase, with a further 5486 Maori women and 2898 Pasifika women taking part in the programme over the 24 month period to December 2010.

“This is a particularly pleasing result, as Maori and Pasifika women are less likely to have breast screening, and have an increased likelihood of dying of breast cancer. These figures show this imbalance is beginning to be redressed.”

Mrs Turia says the percentage of eligible women being screening in all parts of New Zealand has increased.

“Breast screening is undertaken for the National Screening Unit by eight lead providers. All providers have shown an increase in the percentage of women 50 to 69 screened – with an increase of nearly 10% in the Counties Manukau area, and over 7% in the Auckland area.”

“There is, however, no room for complacency and there is still much more that we can do to increase awareness of the benefits of screening”.

Mrs Turia says early detection is the best protection.

“Women with breast cancer that is found early have the best chance of successful treatment, and going on to live full lives, so they can be there for their whanau.”

“Free mammograms are available every two years through BreastScreen Aotearoa for women aged 45-69″, says Mrs Turia. “This free, quick and simple screening test saves lives.”

For further information or to make an appointment, women can ring freephone 0800 270 200, or see the website: nsu.govt.nz.

Background Information

* About 331,000 women aged 50 to 69 have been screened as part of the BreastScreen Aotearoa programme in the 24 months to December 2010. In the previous 24 month period, to December 2008, about 289,700 women were screened.

* Breast cancer is the most common cancer in New Zealand women, and the risk of developing breast cancer increases with age. BreastScreen Aotearoa checks women for signs of early breast cancer by using mammograms – the only proven way for finding breast cancers early enough to reduce the risk of dying.

* Two-yearly breast screening reduces the chances of dying from breast cancer for women under 50 by about 20%, by about 30% for women between 50 and 65, and by about 45% for women aged 65-69.

* Breast Screen Aotearoa aims to screen 70% of women aged 50 to 69.

Obama Cuts Women’s Health Care, Funds Planned Parenthood

President Barack Obama is facing criticism from a conservative group for cutting women’s health care while holding steadfast to funding for the Planned Parenthood abortion business.

Obama refused repeated requests from pro-life House Speaker John Boehner to agree to cut funding for the Planned Parenthood abortion business. However, his administration didn’t raise a stink about the elimination of $600 million for Community Health Centers.

Planned Parenthood, and its defenders, like Obama have used the argument against cutting its funding that women’s health would suffer because the funding cuts would supposedly cut or eliminate legitimate health care programs for women offered by the abortion business. However, the community health centers facing the cuts offer real health care services for women that Planned Parenthood doesn’t provide.

While an expose’ revealed Planned Parenthood doesn’t provide mammograms and its own figures show relatively few women receive pre-natal and post-natal care (about 95 percent of pregnant women get abortions at Planned Parenthood), community health centers provide both.

In an email LifeNews.com received from the conservative American Principles Project, community health centers helped 320,000 women with mammograms, while Planned Parenthood provided none.

“Coating its ideology in flowery language about women’s health and alleged Republican mean-spiritedness, liberal Democrats refused to cut one dime out of Planned Parenthood’s plump federal purse during the budget debate,” APP president Frank Cannon said. “All the while a sharp knife was being taken to community health centers that actually perform full-scale exams for the needy. These health centers offer prenatal care to women and their babies – 480,000 times in 2009 alone. Planned Parenthood? Their 850 clinics average less than one prenatal visit a month, in other words, it’s not their line of work.”

In March, the pro-life organization responsible for recent videos showing Planned Parenthood offering abortions to alleged sex traffickers who prey on women found the abortion business is misleading about mammograms.

Previously, LifeNews.com and pro-life blogger Jill Stanek followed up with phone calls to various Planned Parenthood centers and confirmed they do not do mammograms.

Then, Live Action released videotaped footage of calls to 30 Planned Parenthood centers nationwide in 27 different states where abortion facility staff were asked whether or not mammograms could be performed on site. Every one of the Planned Parenthood centers admitted they could not do mammograms. Every Planned Parenthood, without exception, tells the women calling that they will have to go elsewhere for a mammogram, and many clinics admit that no Planned Parenthood clinics provide this breast cancer screening procedure.

“We don’t provide those services whatsoever,” admits a staffer at Planned Parenthood of Arizona while a staffer at Planned Parenthood’s Comprehensive Health Center clinic in Overland Park, Kansas tells a caller, “We actually don’t have a, um, mammogram machine, at our clinics.”

Live Action president Lila Rose said the recordings further confirm Planned Parenthood’s corruption.

“Planned Parenthood is first and foremost an abortion business, but Planned Parenthood and its allies will say almost anything to try and cover up that fact and preserve its taxpayer funding,” she told LifeNews.com. “It’s not surprising that an organization found concealing statutory rape and helping child sex traffickers would misrepresent its own services so brazenly, playing on women’s fears in order to protect their tax dollars.”