Women often put their families’ health above their own, but there are many reasons why women should be ready to catch their own health problems. Learn from these doctors how to protect yourself.
A woman often holds the time-honored role of caretaker, sometimes putting the needs of her husband, children, parents, grandparents, employer and friends ahead of her own.
Logic dictates, however, that she may not be able to meet the needs of others if she doesn’t take care of herself. Every woman should know not only the basics of a healthy lifestyle, but when to seek a doctor’s help. Catching an impending health problem early ensures good health today, and helps to dodge serious diseases tomorrow.
When it comes to heart disease, Dr. Irina Staicu, a board-certified cardiologist at Advocate Good Shepherd Hospital in Barrington, says a huge difference exists between men and women. Prevention, symptoms, treatment and prognosis are not the only dividers; mortality rates, speed of recovery, potential for recurrence and response to treatment also matter.
“Women, in general, have smaller arteries,” Staicu says. “Plus, they respond differently to stress. This is why prevention is key to avoiding or postponing heart disease in women. Heart disease is the No. 1 cause of death for American women today, more than breast cancer or any other disease.”
Even when they experience the same symptoms of an impending heart event, men respond to treatment better, experience fewer symptoms later and have less chance of recurrence. Despite the rapid advances in heart disease treatment, the gap remains wide.
“One of the best ways for women to avoid heart disease is to begin taking appropriate medications early,” Staicu says. “By starting on statins for cholesterol control, angiotensin-converting enzyme [ACE] inhibitors to maintain lower blood pressure, and possibly aspirin, they can get a huge jump on the factors that can lead to heart disease later on. Women often ask why they should be taking these medications when they have no sign of heart disease. The reason is because it reduces the risks.”
Another preventative is living a healthy lifestyle, which includes a low-fat diet, appropriate exercise, smoking cessation, alcohol and drug abuse cessation, depression and sleep apnea treatment, and positive methods of stress reduction.
According to Staicu, stress and depression are more common for women and pose a significant risk increase. Additionally, anemia, vascular diseases, autoimmune disorders such as lupus, diabetes and other metabolic conditions, and arthritis can contribute to the onset of heart disease in women.
“Women should study their bodies in the mirror,” Staicu says. “If their bodies are apple-shaped, which means they carry excess weight around their waists, instead of pear shaped, with extra weight around the hips, they’re at a higher risk for heart disease.”
Post-menopausal women between the ages of 45 and 60 are at particular risk. Not only are they most likely to die as the result of a first heart attack, but unlike men, they are far more likely to suffer a second heart attack.
“Here’s another significant difference between men and women after open-heart surgery,” Staicu says. “Men respond to the procedure more easily, recover and return to work in about six to seven weeks, and are much less likely to have complications. Women who have open-heart surgery may take up to six months to recover fully, during which time, they may return to the hospital with chest pain. Women also are more likely to need rehabilitation after surgery.”
Reproductive system cancers are another concern for women of all ages. It seems logical to lump them all together, but the truth is, occurrence in reproductive organs is their only similarity.
Dr. Lorraine Novas, board-certified OB/GYN and chair of the Women’s Health Services department at Northwest Community Hospital in Arlington Heights, says that while the uterus, cervix, ovaries and Fallopian tubes are related and appear to be part of the same network, the cancers that attack them are totally different.
“Each type has different causes, symptoms and treatments,” she explains. “For example, cervical cancer almost always originates from the human papilloma virus, and it’s almost entirely preventable, thanks to the vaccine and early detection through routine Pap smears. The vaccine is recommended for women and men ages 9 to 26. After that age bracket, insurance often won’t cover it.”
Often, cervical cancer has no early symptoms, although some may include unusual vaginal discharge, vaginal bleeding between periods, or heavier, longer periods.
“A Pap test reveals precancerous changes in a woman’s cervix, which can be treated in the doctor’s office,” Novas explains. “If the cancer has progressed past the microscopic stages, it’s still fully treatable and curable. Even in later stages, cervical cancer can be successfully treated with radiation.”
Once the leading cause of death among women of childbearing age, cervical cancer mortality rates in the U.S. dropped by 60 percent over four decades following the introduction of the Pap smear.
According to the most recent survey by the National Institute of Health, about 12,000 women are diagnosed annually, and despite available vaccinations, early detection and successful treatments, roughly one-third – about 4,000 – still die from the disease. The most important things a woman can do are to get vaccinated, get regular Pap smears and follow up when a test indicates any kind of abnormality.
“Don’t ever be afraid of following up,” Novas says. “Cervical cancer is preventable and treatable.”
Uterine cancers also can be prevented, by taking basic health measures. Diabetes, high blood pressure and being overweight increase the chances of developing uterine cancer. Also at risk are women who have never given birth, began menstruating before age 12 or experienced menopause after age 55.
However, not all women with these risk factors develop the cancer, and women with no known risk factors can develop it as well. The most common is called endometrial cancer. All should be aware of and pay attention to early warning signs, which include trouble urinating, pelvic pain and unusual vaginal discharge or bleeding.
“Women should be concerned about spotting between periods in their 40s and 50s, and any bleeding after menopause,” says Novas.
Anyone with heavy or irregular bleeding should be screened by her gynecologist, which usually involves an endometrial biopsy and/or dilation & curettage (D&C). “Usually, a hysterectomy is the most effective way to treat this type of cancer,” Novas explains. “The patient should be evaluated by her OB/GYN, because in some cases, she may need to have adjacent lymph nodes removed by a specialist.”
Fortunately, with use of the da Vinci robotic equipment in a surgical setting, the hysterectomy and lymph node removal have become minimally invasive procedures in many cases.
“Uterine cancer is entirely treatable if caught early,” Novas says. “It’s so important for a woman to continue seeing her GYN specialist on a regular basis, and especially if she experiences any bleeding or spotting.”
Unfortunately, cancers of the ovaries and fallopian tubes have no early warning signs nor any standard screening tests. Among the risk factors, the most obvious is heredity.
“Women need to be aware of their family health history,” Novas says. “If there’s a pattern of ovarian or breast cancer, a woman should consider screening for the BRCA1 and BRCA2 genes. It doesn’t necessarily mean she’ll develop cancer, but the odds are higher that she could.”
In addition, women who possess certain other hereditary conditions, fall between the ages of 50 and 80, have never had children, are overweight or taller than 5-foot-8-inches, or have taken fertility drugs or hormone therapy are also at risk. Ovarian and Fallopian cancers are most often found in women between the ages of 60 and 70 but can occur at any age.
“Women whose families have had ovarian and breast cancers in their histories, but who don’t have the BRCA genes, are at no greater risk of developing them than the rest of the population,” Novas says.
Often considered a reproductive cancer, breast cancer will strike one woman in eight, if she reaches age 80. It’s the second leading cause of cancer deaths among U.S. women, exceeded only by lung cancer.
Dr. Chilakamarri Yeshwant, a board-certified oncologist and hematologist with consulting privileges at Presence Saint Joseph Hospital in Elgin, says that each year, an estimated 250,000 women in the U.S. develop breast cancer and nearly 40,000 die.
The known risk factors for developing breast cancer include gender, age, heredity and family history. While men can develop breast cancer, the disease is 100 times more common among women. As you age, your risk increases; about two out of three invasive breast cancers occur in women age 55 or older. Also, the presence of BRCA1 and BRCA2 genes can indicate a higher risk; having a first-degree relative with breast cancer doubles the risk.
Thankfully, the survival rate has improved during the past decade, primarily due to early diagnosis and improved treatments.
Yeshwant stresses the importance of self-awareness and consistent screening. Guidelines for the early detection of breast cancer in average-risk women consist of a combination of regular clinical breast examinations (CBE), counseling to raise awareness of breast symptoms beginning at age 20 and annual mammography beginning at age 40.
“Early detection is one of our primary goals,” Yeshwant says. “This improves chances of cure significantly. Most breast cancers are detected by an annual screening mammogram. For women older than 40, an annual mammogram is recommended, and for as long as their general health remains good.”
Self-examination and CBE have been important ways to detect breast cancers. Yeshwant recommends that women between ages 20 and 30 be taught self-examination techniques and have a CBE by their doctors at least every three years. For women over 40, a frequent self-breast exam and annual CBE by a doctor are recommended, in addition to an annual mammogram.
“Any lumps, changes in shape, dimpling of the skin, retractions or changes in the nipples, could signal breast cancer,” Yeshwant says. “Women who discover any one of these signs should see their physician as quickly as possible. Never ignore them.”
Because about 10 percent of breast cancers have a genetic predisposition, every woman should know her family’s history, especially if first-degree members have had breast or ovarian cancers. A family history of breast or ovarian cancer, especially for women under the age of 40 and/or with a history of male breast cancer, are important factors when considering genetic testing, which can save lives.
Treatments for breast cancer have undergone a great change over the years. “We do minimal surgery for diagnosis and treatment of breast cancer, with much better radiation equipment and techniques to maximize effectiveness and minimize damage to normal tissues,” says Yeshwant. “Treatment options of chemotherapy and/or hormonal therapy are also much better understood, and applied on an individual case-by-case basis, with much better outcomes and fewer side effects.”
Increased awareness, prompt diagnosis and treatment are the key. “The bottom line is that we’ve made great strides in all aspects of breast cancer care in the past decade, but this still remains a very common cancer for women and needs our continued attention,” Yeshwant stresses. “Please seek advice from your doctor promptly if you suspect you or your loved ones have a breast problem.”
Menopause & HRT
Not all women’s health problems are as catastrophic as cancer and heart disease. Menopause looms as one of the life-changing conditions that can really impact a woman’s quality of life. When it interferes with her day-to-day activities, hormone replacement therapy (HRT) can effectively ease the symptoms of menopause and help her to feel better and function more normally.
Symptoms arise as the ovarian function declines and hormone levels decrease. They include, but aren’t limited to, irregular periods, hot flashes, night sweats, vaginal dryness, sleep disturbances, increased abdominal fat, thinning hair and loss of breast fullness. Symptoms can range from mild to severe, depending on the individual.
According to Dr. Melissa Miller, OB/GYN at Sherman Hospital in Elgin, most women begin to experience symptoms between ages 40 and 50. However, a segment of the population begins to have these symptoms at a much younger age – one in 100 between the ages of 30-39, and one in 1,000 between ages 15-29. Early onset or premature menopause can occur for a number of reasons, among them infections such as the mumps, a hysterectomy or tubal ligation, and premature ovarian failure.
“For women who are perimenopausal or menopausal, counseling on the value and risks of HRT is of utmost importance,” Miller cautions. “We base treatment decisions on the individual. What is very bothersome for one woman may not have the same effect on another. When symptoms interfere with work, family and personal aspects of daily life to a disruptive level, we need to discuss the benefits, risks and contraindications before making any decisions.”
Traditional HRT consists of taking supplements of estrogen, progesterone or a combination of both. The basic goal is to maintain the lowest dose possible, for the shortest time possible, for relief of the patient’s symptoms. HRT may be administered in several ways, including pills, patches, vaginal rings or gels, and topical creams; the choice is dependent on the patient complaint.
For example, because therapeutic levels aren’t reached in the blood, vaginal or topical cream won’t affect hot flashes, but it will do wonders for vaginal dryness. For systemic symptoms, such as hot flashes or night sweats, oral tablets are most effective.
HRT does come with health risks, including blood clots, strokes and, with estrogen/progesterone combination therapy, an increased risk of heart disease or. breast or endometrial cancer
“This is why we limit HRT to the shortest time needed to ease a woman past the worst symptoms of menopause,” Miller stresses. “Usually, HRT is continued for five to seven years past menopause, but there are some patients whose symptoms are so distressing that we must continue therapy for a longer duration.”
Miller monitors HRT patients closely, typically seeing each one month after initiation of therapy, to evaluate to what degree her symptoms have improved and decide if she’s on the correct dose.
“Once the patient’s relief goal is reached, I’ll see her approximately twice yearly,” says Miller.
In the meantime, Miller encourages her HRT patients to report as soon as possible any abnormal vaginal bleeding, breast lumps, shortness of breath or other concerning symptoms that may arise. When the time comes to end HRT, Miller says she tapers the dosage gradually.
“I believe an abrupt change of this nature isn’t typically well-tolerated,” she says. “The body needs to acclimate to the withdrawal over time, so that the patient doesn’t experience symptom rebound.”
Even the busiest of women need to be mindful of their health. Despite the abundance of information, the process is actually pretty simple.
Get regular physical examinations at least once a year, and be aware of your body and its changes. Add a healthy lifestyle that includes maintaining an appropriate weight, regular exercise, adequate sleep and avoiding (or cutting back on) damaging habits. While there’s no proven formula for avoiding major diseases entirely, there is ample proof that a healthy lifestyle will lay the groundwork for surviving whatever comes.