You Are Not Too Old To Have Mammogram

Many of my older patients don't come to the office so they can be screened for breast cancer through mammography. A recent study of women aged 80 to 84 showed that those who had regular mammograms had their breast cancer diagnosed earlier as opposed to those who had infrequent mammograms. It means that you're not too old to have your mammogram.


Reference:Journal Watch

Women Positive About Aging

A recent poll on women on their attitudes towards aging showed that many said the best was yet to come. Please, read more:

CHP Lorain Spirit of Women Wins National Recognition

Mario Sertich, MD, introduced the spirit of women to the Lorain Community Hospital. This organization aims at bringing women's attention to different programs in the community hospital. Please, read on:

Depressed Women May Have Premature Babies

A study done in England on depressed pregnant women showed the severely depressed women who were not taking medications had premature labor.

That depression produces stress hormones is exemplified by this study. Dr. O'Keane, a perinatal psychiatrist at the King's College in London measured corticotrophin releasing hormone (CRF) in 25 depressed pregnant women who were not on any antidepressant medications and 35 pregnant women who had no depression.

Levels of CRF and cortisol, hormones related to stress and also produced  by the placenta in pregnancy were found to be higher in women with depression.

While none of the mothers that were not depressed had premature deliveries, on the average, the depressed mothers had their babies 2 days earlier and 3 of them had premature deliveries.

During the follow up visit, the babies whose mothers had depression had high levels of cortisol in their saliva, a sign that their mothers' stress had effect on them..

The study involved a few patients. More studies are needed to elucidate the findings of this interesting small study. The take home message is that depressed pregnant patients' stress may have effect on their unborn babies. The effect may even continue after delivery. Hence pregnant women who are depressed should be treated with antidepressants despite the fear that some of the antidepressants may have effect on the newborn babies.

 

Reference: From issue 2599 of New Scientist magazine, 14 April 2007, page 18

Estrogen Therapy is good for the Young Postmenopausal Woman’s Heart.

The estrogen therapy controversy has not been put to rest yet. The WHI study that was highly publicized showed that postmenopausal women who took estrogen did not benefit from the estrogen replacement therapy and may even be at an increased risk of having heart disease.

In 1994, the Women Health Initiative trial using estrogen alone showed no adverse effect from the estrogen therapy. That study was stopped prematurely.

A study published by Manson and her colleagues in the most recent New England Journal of Medicine showed that estrogen therapy in younger women (50 -59 years), who have recently undergone hysterectomy with removal of their ovaries and hence have had surgical menopause, have protection against heart disease by keeping the lumen of the blood vessels open. Without the estrogen, calcium is deposited in the walls of the blood vessels thus causing narrowing.

The take home message is that in women who have had hysterectomy with removal of their ovaries in their 40’s to early 50’s, estrogen replacement therapy may be beneficial to the heart as it slows down the narrowing of the blood vessels.

Cervical Cancer Vaccine May Prevent Precancerous Changes on the Cervix

An article published in the May 10th New England Journal of Medicine showed that young women not infected with Human Papilloma Virus HPV 16 and 18 who were vaccinated with the Gardasil vaccine had a lower occurrence of the high grade precancerous diseases on the cervix than those who were vaccinated with placebo.

The study was done on 12,167 women aged 15-26 years who had not been previously infected with the HPV. Thus the vaccine, if given to young women who have not already been exposed to the Human Papilloma Virus, is effective in preventing cervical dysplasia in women that will be apparent within years rather than decades.

"Human papillomavirus types 16 (HPV-16) and 18 (HPV-18) cause approximately 70% of cervical cancers worldwide,"

Laura A. Koutsky, PhD, from the University of Washington in Seattle, and colleagues from the FUTURE II study group.

Reference:N Engl J Med. 2007;356:1915-1917.

Australian Women Seeking Vaginal Plastic Surgery

Many unmarried Australian women are seeking plastic surgery to improve the look of their vulva according to Dr. Colin Moore, a plastic surgeon who has been performing this kind of surgery for about 30 years.

Dental Care In Pregnancy Can Prevent Premature Labor

Gum disease has been found to cause heart disease because of the increased production of the C-Reactive Protein. The level of the C Reactive Protein decreases when the gum disease is treated. It is therefore interesting to find that a similar mechanism can affect the outcome of childbirth.

A recent study that appeared in the American Journal Of Obstetrics and Gynecology showed that gum disease can cause premature labor. Among 1020 pregnant women who were followed in pregnancy, 28.6% women with moderate to severe periodontal disease had preterm delivery as compared to 11.2% of women with no periodontal disease. The authors concluded that gum disease in pregnancy is a predictor of premature labor.

Hence dental care should not stop in pregnancy. It will be more prudent for women who want to get pregnant to see their dentist to give them a clean bill of dental health before they get pregnant.

Reference:

Offenbacher et al

Obst Gynec. 2006, 107:29-36

Hormone Replacement Therapy Linked To Ovarian Cancer.

Ovarian cancer is a deadly disease. Up till now there has not been any significant test to screen for the disease in its early stages. The recent finding from a British study that appeared in the Lancet is frightening since its use may have resulted in a thousand deaths since 1991. The study was from the million women study. 30% were current users of hormone replacement therapy and 20% were past users. Current users had 1-2 fold greater risk for ovarian cancer than never user. The highest risk was for serous tumors in women with epithelial cancer, with current users at 1.53 times the risk as never users. The consensus is that current advice to take estrogen replacement therapy will not change however women should take hormone replacement therapy for a short time.