Women's Health Archive

Ask the doctor

Q. I've heard that bioidentical hormone pellets injected near the hip are more effective than bone-building drugs in stopping bone loss and preventing hip fracture. Is this true?

A. The FDA hasn't approved hormone pellets for preventing or treating bone loss. Moreover, there are no randomized controlled trials on record, so we don't know whether hormone pellets are more effective — or even as effective — as the FDA-approved medical therapies. Finally, there aren't any published reports explaining how the hormones are metabolized in the body or the side effects they may have.

Hemorrhoids won't go away, but some simple measures can help to prevent and ease flare-ups.

 Image: © Wavebreakmedia/Thinkstock

By some estimates, about half of people over age 50 have hemorrhoids — swollen blood vessels on the outer rectum and anus. Women are more likely than men to develop hemorrhoids, probably because hemorrhoids commonly occur during pregnancy. However, they are less likely to seek medical treatment for them.

Not all hemorrhoids cause problems. One study of people undergoing colonoscopy found that more than half of people whose tests revealed hemorrhoids were unaware that they had them. However, when hemorrhoids become inflamed, they can make bowel movements — and even sitting — quite painful.

Research we're watching

Ductal carcinoma in situ (DCIS) differs from breast cancer because it is noninvasive, so it cannot spread to other parts of the body. However, it can progress to an invasive breast cancer, which can be life-threatening. Researchers from the Netherlands Cancer Institute wanted to determine how DCIS affected long-term survival.

The team studied almost 10,000 postmenopausal women who were diagnosed with DCIS between 1989 and 2004. They tracked the patients over an average of 10 years and compared their death rates with the expected mortality rates of the general population. They found that women who had been treated for DCIS had a 2.5% risk of dying of breast cancer over 10 years and a 4% risk at 15 years — rates that were higher than in the general population. But they also found that DCIS survivors had a 10% lower risk of dying from any cause compared with the general population. They presented their results Jan. 27, 2017, at the European Cancer Congress.

If you are thinking about getting pregnant, you can do many simple, effective things right now to improve your chances of conception, because lifestyle can have profound effects on the reproductive functions of women and men. This means that increasing your fertility potential is something that you both can do without outside help. In addition to adopting a fertility-boosting diet and getting into the fertility zones for weight and exercise, there are a number of lifestyle choices you can make for improving fertility naturally.

Give up nicotine, marijuana, cocaine, and steroids

Tobacco smoking has been linked to reduced fertility in both women and men. In addition, a recent British study has found an association between smoking and stillbirths, low birthweight babies, and sudden infant death syndrome (SIDS). A woman who smokes is likely to have less chance of becoming pregnant and giving birth when treated with in vitro fertilization (IVF) than a woman who doesn't smoke. This is especially true if she smokes twenty or more cigarettes a day. A mechanism that may link cigarette smoking and reduced pregnancy rates following IVF is the observation that smoking appears to accelerate the rate of egg loss. Women who smoke have the elevated hormone levels that indicate a depleted supply of eggs and prematurely aged follicles.

Heart disease is the leading cause of death among women — and one of the most preventable. Research is giving us insights into how we can control our risk.

We've come a long way since the days when a woman's worry over heart disease centered exclusively on its threat to the men in her life. We now know it's not just a man's problem. Every year, coronary heart disease, the single biggest cause of death in the United States, claims women and men in nearly equal numbers.

Risk still underappreciated

In a survey conducted by the American Heart Association, about half of the women interviewed knew that heart disease is the leading cause of death in women, yet only 13% said it was their greatest personal health risk. If not heart disease, then what? Other survey data suggest that on a day-to-day basis, women still worry more about getting breast cancer — even though heart disease kills six times as many women every year. Why the disconnect?

You could argue that the physical and mental changes that occur during menopause aren't really "symptoms." The term is usually associated with a disease, which menopause is not. Also, it is often hard to say which changes are a direct result of a drop in hormone levels and which are natural consequences of aging. Some of the symptoms overlap or have a cascade effect. For example, vaginal dryness may contribute to a lower sex drive, and frequent nighttime hot flashes may be a factor in insomnia.

Hot flashes and vaginal dryness are the two symptoms most frequently linked with menopause. Other symptoms associated with menopause include sleep disturbances, urinary complaints, sexual dysfunction, mood changes, and quality of life. However, these symptoms don't consistently correlate with the hormone changes seen with menopause transition.

For too many women, joyfully anticipated pregnancy and motherhood bring depression as an unexpected accompaniment. Children as well as mothers suffer. Depression during pregnancy may result in poor prenatal care, premature delivery, low birth weight, and, just possibly, depression in the child. Depression after childbirth (postpartum depression) can lead to child neglect, family breakdown, and suicide. A depressed mother may fail to bond emotionally with her newborn, raising the child's risk of later cognitive delays and emotional and behavior problems. Fortunately, if the depression is detected soon enough, help is available for mother and child.

Depression During Pregnancy

Depression in pregnant women is often overlooked, partly because of a widespread misconception that pregnancy somehow provides protection against mood disorders. In reality, almost 25% of cases of postpartum depression in womem start during pregnancy, and depression may peak at that time, according to a study published in the British Medical Journal.

Greenery might do more than just cheer us up. A recent study shows it lowers the mortality rate in women. Green spaces decrease levels of depression and pollution while increasing levels of social engagement and physical activity. If you are lucky enough to be surrounded greenery, get out there and enjoy it more. Even urban areas can increase their greenery by planting more trees and shrubs. See if you can get your community to plant more plants. It will help everyone out in the long run.

This list describes your priorities in an emergency situation. Follow these steps:

1. Evaluate the scene to protect yourself and others from injury or danger.
2. Be calm and reassuring.
3. Do not move the person unless he or she is in imminent danger or unless you cannot provide assistance without moving the person.
4. Get help. Call out for someone to phone 911 or, if the person does not need immediate assistance, make the call yourself.
5. If the situation is a choking emergency, perform the Heimlich maneuver (see Choking).
6. Look, listen, and feel for breathing (see Breathing Difficulties).
7. Feel for a pulse to determine if the heart is beating.
8. Control bleeding with direct pressure.
9. Treat for shock.
10. If the person is unconscious, move him or her into the recovery position.

Adult Recovery Position

This position helps a semiconscious or unconscious person breathe and permits fluids to drain from the nose and throat so they are not breathed in. If the person is unconscious or semiconscious after you have done everything on the Emergency Checklist, move the person into the recovery position while waiting for help to arrive.

Do not use the recovery position if the person has a major injury, such as a back or neck injury