2019 Women’s health update- hormones, the heart, and HPV

Multiple health issues impact women exclusively or differently than men, so new and updated information is important to share. The issues we women face vary with our age, stage of life and health status.

Let’s look at some medical news about women’s health issues, information I picked up recently from several medical journals I follow.

This is current, general medical information that helps a doctor and patient make decisions about what is right for her. Medical recommendations and practice changes as we learn new things.
If you deal with any of these issues , please discuss with your doctor before  taking any action.

I’m illustrating this post with photos of art featuring women. I’ll tell you more about the source at the end.

statue of a woman holding an infant

Human papillomavirus and cancer 

Infection with the human papillomavirus, HPV, can cause  genital warts and cervical cancer.

The percentage of young women with confirmed HPV (human papillomavirus) infection  in the United States fell significantly from 2006 to 2012. Women who had received the HPV vaccine showed the greatest decline in infection rates, compared to those who had not. Even one dose was effective, even though 2 or 3 are recommended.

A new study reported by the New England Journal of Medicine shows that women who become infected with the HPV strains 16 and 18 have a much higher risk of changes in their cervix called CIN-cervical intraepithelial neoplasia-which can be a precursor to cancer. These changes may not be picked up by a Papanicolaou (Pap) test.

Thus, protection against infection with HPV should also provide protection against cancers caused by HPV.

Human papillomavirus vaccine

Gardasil, a vaccine which targets the HPV has been available to females and males from 9 years old to 26 years old. Now the age has been extended through age 45 years for both genders.

Here is a link to detailed information about HPV vaccination from the National Cancer Institute.

Human Papillomavirus (HPV) Vaccines

statue of a pioneer woman with rifle and infant

Long-acting reversible contraception-LARC  

Two forms of long-acting reversible contraception are available to women in the United States.

Nexplanon, a contraceptive implant, slowly releases the hormone progestin and does not have estrogen. It can be used in women who cannot take estrogen, such as those with uterine fibroids or endometrial cancer.

Intrauterine devices, IUDs, containing copper only are appropriate for women with past or present breast cancer, ischemic heart disease, and women at risk for blood clots.

Use of LARCs accounts for 12% of all contraceptive use. Additional benefits include controlling excessive menstrual bleeding, potentially saving women from surgery.

Here is a link to Quick Fact about intrauterine devices and other forms of contraception from the Department of Health and Human Services

Intrauterine Device

statue of woman, holding infant, standing next to a child

Hormone therapy and prevention of heart disease

A 2015 Cochrane review of 40,410 postmenopausal women examined the use of oral hormone therapy (estrogen with or without progesterone) taken for at least six months, compared with placebo (no real drug), to determine the effect on death from any cause, and deaths caused by heart disease, stroke, and blood clot in a leg or lung.

The review found no benefits for preventing heart attack (fatal or nonfatal), or death due to any cause.

In women who took hormones they found

1 in 165 women had a stroke
1 in 118 women had a blood clot in the leg or lung
1 in 242 women had a blood clot in the lung

The women in this study were all older than 60 years old, so it is possible there might be benefit in younger women.

statue of woman with arm raised and holding an infant

Vaginal estrogen and heart health

While estrogen replacement after menopause is effective at controlling the undesirable effects of night sweats, hot flashes, and vaginal dryness, it potentially increases the risk of developing cardiovascular disease-heart attacks and stroke, and some cancers-breast and uterine.

However, results of the Nurses Health Study over 18 years shows no increase in incidence of these complications in women who used vaginal estrogen, suggesting this is a safe option for women who elect to use estrogen. (from the journal Menopause)

The photos- a tribute to women

I took these photos during a recent visit to Woolaroc ,a museum and wildlife preserve located in the Osage Hills of Northeastern Oklahoma. Woolaroc was established in 1925 as the ranch retreat of oilman Frank Phillips. 

These statues displayed there were all models considered for a larger project now known as the Pioneer Woman Statue in Ponca City, Oklahoma.

What do you think? Would you have chosen one of the other statues for the final version?

More women’s health info

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                              Dr. Aletha 

a statue of a woman holding a child, "CROSSING THE PRAIRIE"
“CROSSING THE PRAIRIE” by Glenna Goodacre, Broken Arrow, Oklahoma
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5 gems of women’s health

Some  health issues impact women exclusively or differently than men, so we should be aware of new and updated information .  The issues we women face vary with our age, stage of life, and current health status.

In this post I offer “gems” on women’s health issues from women who are “gems” themselves- women physicians who practice medicine as well as take time to write about important health issues. 

 I’m illustrating this post with photos of women from one of my affiliates, Lightstock, a stock photo site. You can help support this blog by purchasing from this link. Click now to get 5 free downloads. According to Lightstock,

“Our library is large enough to cover all of your needs, but our faith-focused stock is one of a kind. No other company comes close to matching our quality and quantity.”

This post also has Amazon affiliate links.

Dr. Danielle Ofri offers

A Doctor’s Guide to a Good Appointment

Dr. Ofri explains how to find a doctor – online ratings sites are not always reliable. A good first step is -Check with your insurance to find a doctor who is in network.

Next she lists steps to prepare for the appointment. Establish goals for the visit, make a list, and gather any recent, pertinent medical records.

She goes to give some practical tips on what to do and say during the interview and physical exam. Read her post to learn more.

Dr. Ofri practices in New York City where she is also a professor at a medical school. She writes extensively and has spoken for TED Talks. You may want to read Dr. Ofri’s book, What Patients Say, What Doctors Hear. Here is my review . 


you cannot love without giving. Amy Carmichael


OBdoctormom explains

8 Things Your Doctor Wants You to Know About your Miscarriage

“Miscarriage is one of the hardest (and most common) challenges women face. If you have not had a miscarriage yourself, you most certainly have a best friend, sister, or daughter who has. There are many myths floating around the internet, however there are a few important truths everyone should know about miscarriage.”

woman sitting in a cemetery

photo from the Lightstock.com collection, an affiliate link

A psychiatrist, Dr. Melissa Welby lists and discusses

3 New Year’s Resolutions to Benefit Your Mental Health

  • Sleep better
  • Volunteer
  • Exercise

5 gems of women's health-Watercress Words.com

 In Go Pink ,Secret Life of an OB/GYN

answers typical patient questions about breast cancer and mammograms, including the latest recommendations for screening.

“Only 5 to 10 percent of breast cancers are familial (someone in your family has it). That means 90 to 95 percent are spontaneous, with NO family history. So don’t let your lack of family history of cancer lull you into thinking you have no risk and no reason for screening.”

a middle aged woman and a young woman together

Breast cancer can strike women of any age, although happens more often in older women.

Dr. Barbara Bergin, an orthopedic surgeon, offers tips to prevent foot pain and injury in an interview for Massage magazine.

  • Buy healthy shoes(and wear them)
  • Wear the right socks
  • Stand on a floor pad
  • Keep your feet warm

an African American young woman smiling

And a bonus gem-

Dr.Diana, an allergist who blogs at WHITE COAT PINK APRON

offers this recipe for ROASTED BRUSSELS SPROUTS WITH GARLIC , a vegetable I love. But if they’re not your favorite vegetable (or your family’s) , here is one for ZA’ATAR ROASTED CARROTS White Coat, Pink Apron web site

You may also want to review my previous post about women’s health

The “art” of women’s health- news from 2016

where I covered hormone therapy, the HPV vaccine, birth control pills, IUDs, hysterectomy, and osteoporosis.

The human heart tells us that we are more alike than we are unalike. quote Maya Angelou

graphic by Lightstock. quote by author Maya Angelou 



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Dr. Aletha  26952564_10213093560871954_4239554644472378905_o

The “art” of women’s health- news from 2016

Multiple health issues impact women exclusively, so new and updated information is important to share. The issues we women face vary with our age, stage of life and health status.

In this post I review the  Women’s Health Top 10 Stories of 2016 chosen by the NEJM (New England Journal of Medicine) Journal Watch editors. Topics include HPV infection, contraception, pregnancy, hysterectomy, menopause, and osteoporosis. The articles are not ranked by importance.  I’ve also included other links on these topics for your reference.

 I’ve chosen to illustrate this post with photos of art featuring women- all taken by me, on my travels.

statue of young woman

at the Santa Fe, New Mexico airport

Does the HPV vaccine prevent cervical cancer?

Infection with the human papillomavirus, HPV, can cause  genital warts and cervical cancer.

The percentage of young women with confirmed HPV (human papillomavirus) infection  in the United States fell significantly from 2006 to 2012. Women who had received the HPV vaccine showed the greatest decline in infection rates, compared to those who had not. Even one dose was effective, even though 2 or 3 are recommended.

The HPV vaccine, first released in 2006, was developed in the hope of decreasing cases of cervical cancer. It’s still too soon to tell if less infections will mean less cancers, since cervical cancer develops slowly over time.

statue of a dancing lady

“The Dance” statue at the University of Oklahoma, Norman, OKlahoma

Do birth control pills cause side effects? 

Most women tolerate hormonal contraceptives without problems, but some experience troublesome side effects . In two medical studies of women using various forms of hormonal contraceptives, researchers asked about weight and libido. The women were using all forms of hormone birth control- pills, patch, implant, IUD, long acting progesterone shot, and the vaginal ring.

Based on measurement, significant weight gain did not occur, although women often reported  they had gained weight. Some women reported a change in their interest in sex; however, many factors affect libido so the  hormones might not be entirely to blame.

Neither  study confirmed  hormones caused  weight gain or loss of interest in sex.

crystal statue of a kimono

Oklahoma City Museum of Art

How long are IUDs  effective and safe?

The IUD (intrauterine device) contraceptive  marketed in the United States as Mirena is currently approved for 5 years of use but this study showed it  effective for as long as 7 years with no increase in side effects or complications.

statue of woman with 3 children

Metropolitan Museum of Art, New York City, New York

How can we stop premature delivery of babies?

Obstetricians may  prescribe progesterone to high risk women to prevent premature birth. A study done in the United Kingdom found that women who used a  daily progesterone by vaginal suppository did not have fewer premature births compared to women who did not use it.

This method may not be reliable since  it’s difficult to accomplish regularly; giving a shot may be more effective.

painting of woman in blue dress and bonnet

at the Metropolitan Museum of Art, New York City, New York

Are you one of the million women who has a c-section every year?

Obstetricians use several different surgical techniques when performing cesarean delivery, the most common major surgery performed in the United States. After a c-section, some women experience  pelvic pain, painful periods, hernias, infertility and problems with future pregnancies.

In a  review of 15,000 women who had c-sections the chance of having a future problem did not vary  based on the type of  surgical method used. The reviewer suggested that the experience of the surgeon is probably a more important factor.

ice skater statue

Olympic Training Center, Colorado Springs, Colorado

Controlling diabetes during pregnancy makes healthy babies.

Controlling blood sugar in women with type 1 diabetes is challenging and especially important during pregnancy. High blood sugar, hyperglycemia, can harm both mother and baby. 

A small study of British patients used a closed-loop insulin delivery system to control blood glucose (sugar) by adjusting insulin based on measuring glucose levels in the blood .

This glucose sensor and pump controlled by a computer  kept glucose in the target range better than not using the computer. Hopefully, the cost will come down and make it accessible to more patients.

Jesus and a woman-painting

Christ and the woman of Samaria, Houston Museum of Art

If you had or are having a hysterectomy for a benign (non- cancer) problem,should you leave the ovaries behind?

Many pre-menopausal women who need a  hysterectomy- removal of their uterus- keep their ovaries in place, hoping to preserve hormone effects until they would have naturally reached menopause. But the reported study found that after hysterectomy a significant number of women started menopause sooner than those who had not, about 2 years earlier.

Native American woman-painting

at the University of Oklahoma

Is estrogen safe for your heart? 

When the Women’s Health Initiative Study in 2002 suggested estrogen increases the risk of heart attacks, physicians and patients quit using  hormones to treat menopause symptoms like hot flashes.

A new study called ELITE, looked at artery thickness in women on estrogen compared to those not taking it; this is an indirect way to estimate the  risk of heart attacks and strokes. This study found no significant differences, indicating that estrogen is probably safe to use when needed to control symptoms;  but is still not recommended to use routinely for prevention as we once thought it could be.

mural of women in costumes

at the Performing Arts Center, Tulsa, Oklahoma

If you take estrogen, should you take a pill or wear a patch ( transdermal) ?

This article reviewed  5000 women who used either estrogen pills or an estrogen patch for over 10 years. Although  few women in either group had a vascular complication, more women who took a pill had a venous thromboembolism (blood clot in a vein),  heart attack or stroke, than women who used an estrogen patch. The patch is probably safer.

wood carving of african woman

at the Hemingway House, Key West, Florida

Will  your osteoporosis treatment keep  your bones strong enough?

Women often develop thin bones due to postmenopausal osteoporosis (due to loss of estrogen). Thin bones make women more at risk for fractures with a fall.

Doctors diagnose osteoporosis based on low BMD, bone mineral density; the aim of therapy is to increase BMD and prevent fractures. Do you need a repeat test to tell if therapy is effective?

This study suggested yes, since a significant number of patients lost density while on therapy. If this occurs, you may need a different therapy or be evaluated for other problems.

These medical studies produce general medical information to help a doctor and patient make decisions about what is right for her. They are based on current information , but may change as we learn new things. If you deal with any of these issues , please discuss with your doctor before  taking any action.