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

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)

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

exploring the HEART of women’s health

Dr Aletha

a statue of a woman holding a child, "CROSSING THE PRAIRIE"
“CROSSING THE PRAIRIE” by Glenna Goodacre, Broken Arrow, Oklahoma

AAPTIV- what I’m using to stay fit now.

 

Preventing bacterial infections

 

Prevention is a focus in healthcare now  and immunization has  been one of the most effective ways to prevent disease ever developed.

The list of diseases that are “vaccine preventable” is long and continues to grow.

Go here for the latest recommendations and guidelines on immunization from the  National Center for Immunization and Respiratory Diseases (NCIRD)

Vaccine recommendations may be based on a person’s

  •  age,
  • gender,
  • ethnicity and
  • concurrent conditions, especially diabetes mellitus, chronic lung diseases, heart disease and  immune suppressing disorders.

Vaccine administration may vary by

  • the number of doses recommended,
  • how far apart the doses should be given, and
  • which vaccines can be administered at the same time.

Immunization protocols have  become so complex that even physicians have difficulty keeping it straight without the use of paper or digital checklists. This is one area where the Internet and EMRs (electronic medical records) can be useful.

Find out what vaccines your child needs for protection against common  infections. 

 

 

Vaccines for infections caused by bacteria

I use the name of the disease and/or the bacteria, rather than the vaccine name, since there are different brand names for the vaccines depending on the manufacturer.

So successful have these vaccines been that most young doctors have never seen a patient with these diseases (unless perhaps they specialize in infectious disease, immunology, emergency medicine or critical care). And even I, who graduated medical school in 1978, have only seen a few, and none in recent years.

Diphtheria-primarily a respiratory tract illness in young persons

Pertussis, better know as whooping cough, also a respiratory illness, which has made a comeback in recent years, apparently due to a waning of immunity

Tetanus, also called “lockjaw”– due to a toxin which may contaminate a dirty wound

Menigococcal disease, which is one of many causes of meningitis (inflammation of the brain lining), but one of the most deadly, even with treatment

Streptococcal pneumoniae disease; the vaccine is often referred to as the “pneumonia vaccine”, but the bacteria can also cause ear infections, sinusitis, meningitis and sepsis (bloodstream infection)

Haemophilus disease is similar to pneumococcal, but more of a concern in infants and children

 

Preventing viral infections

Virus vs Bacteria One major difference between bacterial and viral infections is the treatment. We have many more effective antibiotics (drugs which fight bacteria) than we do antiviral drugs. And antibiotics do not affect viruses. Despite that fact, patients often expect and even demand their physicians prescribe antibiotics for viral infections such as influenza, colds…

 

exploring the HEART of infection control

 

Dr Aletha

 

 

 

 

 

 

          

 

 

 

 

 

 

 

 

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