WOMEN S HEALTH May 2017

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1 Ohio Northern University HealthWise WOMEN S HEALTH May 2017 MAY IS WOMEN S HEALTH MONTH Osteoporosis Page 2 Breast Health Page 3 Hot Flashes Page 4 Menstrual Disorders Page 5 Celebrate your Health May is a month to encourage women to make their health a priority. It is a great time for women to feel empowered to take charge of their health. Women s health covers a wide variety of topics, including breast health, osteoporosis, and menopause. There are so many ways that women can take charge of their health. Find out how in this month s issue of the ONU HealthWise Newsletter! Go Bears! Taylor Fox, Allison Fye, Hannah English, Zachary Brock PharmD Candidates 2017

2 OSTEOPEROSIS Bone health and strength are something that can be easily overlooked by patients and healthcare professionals, but they are a very important aspect of women s health. Osteoporosis is the most common type of bone disease. In the United States, roughly 1 in 4 women over the age of 50 have osteoporosis compared to about 1 in 8 men. Approximately 37,500 people die each year after complications related to an osteoporotic fracture. From these statistics it is evident that we should be aware of what osteoporosis is, how it can affect our bodies, and most importantly, what to do to prevent it. Generally speaking, osteoporosis is a combination of poor bone mass and accelerated bone loss which leads to weakened bones and a higher fracture risk. Our peak bone mass occurs when we are between the ages of 18 and 25. Peak bone mass is highly dependent on genetics, but can also be influenced by nutritional intake, exercise, smoking, and hormonal status. After it peaks, bone mass plateaus for approximately 10 years, then it begins to decrease % per year. Once women hit menopause, bone mass decreases by nearly 5-7% per year and then lowers again when menopause ceases. Bone mass is higher in males than females and higher in African Americans than Caucasians or Asians. Weight bearing exercise and physical activity can also positively impact your bones and decrease your risk for osteoporosis. There are different ways to screen for osteoporosis, but the peripheral dual energy x-ray absorptiometry (DXA) is one of the most common. This measures the bone mineral density (bone mass/strength) in the arm, wrist, finger or heel. If a patient is at risk and has poor results, he/she can have a central DXA (hip/spine) done which is the gold standard for diagnosing osteoporosis. Patients bone strength can be classified by a T-score which helps determine when to start medications. Prevention of this disease is key. Ways to prevent osteoporosis from occuring would be to include more calcium and vitamin D in our diet. Consult a physician or pharmacist to see how much is enough based on your age and which calcium or vitamin D product to select. Another way to help prevent osteoporosis is limiting alcohol, caffeine, and tobacco intake. It is also important to ask your pharmacist about the medications you are taking to see if they could be affecting your bone mass. There are several approaches to preventing osteoporosis so following the above tips and guidelines is certainly recommended. -National Osteoporosis Foundation. 54 Million Americans Affected by Osteoporosis and Low Bone Mass. Washington DC: National Osteoporosis Foundation; Retrieved April 19, 2017 from -National Osteoporosis Foundation. Bone Density Exam/Testing. Arlington (VA): National Osteoporosis Foundation; Retrieved April 19, 2017 from -National Osteoporosis Foundation. What is Osteoporosis? Washington DC: National Osteoporosis Foundation; Retrieved April 19, 2017 from Women s Health 2 ONU HEALTHWISE

3 BREAST HEALTH Breast cancer is a serious and common form of cancer that affects 1 in 8 women in the course of their lifetime. It is important to know the risks associated with breast cancer and what actions can be taken to help detect breast cancer at an earlier stage. Although some of these risk factors are out of the control of the individual, some have the potential to be modified. It is important for women to be aware of the risk factors that can be controlled and to take steps in order to keep their risk as low as possible. Mammograms are essential in screening and diagnosing breast cancer. A mammogram is an X-ray image of the breast. Although mammograms are not perfect, they are capable of finding breast cancer in the early stages and in turn, can help save lives. By finding breast cancer early, more women are able to be treated with the proper medications and more women are able to avoid surgery. Women should begin getting mammograms once a year starting at age 40. If a woman is at an increased risk for breast cancer, mammograms can start at an earlier age to provide the most benefit. Mammograms are safe, last about 20 minutes, and provide minimal discomfort for women. Women that have a suspicious mammogram may need further testing. Other than getting regular mammograms, women should be aware of the benefits of performing breast self-exams each month and having regular breast exams by their doctor. These steps can help to identify irregular lumps in the breast. It is important for women to know their body and what is normal for them. If a woman feels something out of the ordinary during a breast self-exam, it is important for them to contact their physician. It is important for women to be proactive in regards to their breast health and speak up when something out of the ordinary appears. Early detection is key! Mammograms There are two different types of mammograms, film-screen or digital, that can be used to help detect breast cancer. Film screen mammograms are recorded in black and white on large film sheets while digital mammograms are recorded on computer screens. With digital mammograms, doctors are able to increase areas of the image to take closer looks at the breasts to determine if there are suspicious lumps. Women should talk to their doctor to determine which mammogram is appropriate for them. Risk Factors Associated with Breast Cancer Older age Female Caucasian Family history of breast cancer Overweight Smoking Unhealthy diet Orel S, Conant E, and Weiss M. BreastCancer.org; Screening and Testing [cited 2017 Apr 23]; [about 4 screens]. Available from: Women s Health 3 ONU HEALTHWISE

4 HOT FLASHES Host flashes most commonly occur when a woman s menstrual cycle begins to cease and menopause occurs. Nearly 80% of women experience some type of hot flash during the menopausal transition. Most hot flashes present with sudden feelings of warmth that are more intense over the face, neck and chest. These flashes usually subside over seconds to minutes, but can vary in frequency, intensity, and duration. Women who smoke, are overweight, are physically inactive, and who are African American are at a higher risk of experiencing hot flashes. There are multiple different treatment options for women whose hot flashes are so severe that they interfere with their quality of life. One option for the treatment of menopause is the use of hormone therapy to replace the hormones that are naturally lost during menopause. It is only available by prescription, as it is important to talk with your doctor about the risk versus benefit aspect of this type of medication. There are other medications that have been proven to be effective at treating hot flashes that are only available by prescription. As with hormone therapy, these medications are associated with certain side effects; therefore, your doctor may choose one of these options based on which is best for you. If you do not wish to take a medication for hot flashes, there are changes you can make in your daily routine to help cope with them. It is important to set the room temperature lower and dress in layers that can be easily taken off if a flash occurs. It is also recommended to reduce intake of hot beverages, caffeine, spicy food, and alcohol, as these can all trigger a hot flash. It is also recommended to reduce stress, exercise more, and lose weight. Although hot flashes are not enjoyable to experience, it is good to know that there are options available to make them more tolerable! HERBAL SUPPLEMENTS There are a variety of herbal supplements that have been used for the treatment of hot flashes. The effectiveness for the treatment of hot flashes is unknown, and it is important to talk to your doctor or pharmacist before starting any new supplement. The most common herbal supplements used to treat hot flashes are Phytoestrogens and black cohosh. Phytoestrogens come from plants and can be found in foods such as soybeans and lentils. Black cohosh is also derived from a plant and is associated with stomach cramping and headaches. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; 02 Oct Hot Flashes [cited 27 Nov 2016]; [about 10 screens]. Available from: Goodman NF, Cobin RH, Ginzburg SB, et al. American Association of Clinical Endocrinologists (AACE) Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Menopause. Endocr Pract. 2011;17(Suppl 6): Women s Health 4 ONU HEALTHWISE

5 MENSTRUAL DISORDERS Some women get their periods every month like clockwork. They come and go causing only a minor inconvenience; however, there is a large group of women who experience numerous physical and/or emotional symptoms before, during, and after menstruation. Some of these symptoms range from severe cramps and heavy bleeding to mood swings and even missed periods. Most menstrual disorders have an explanation and treatment options exist. Your period is part of your menstrual cycle which is a series of hormonal changes that occur every 28 days. The first day of your period is day 1 of your menstrual cycle. The average period lasts 5-7 days but keep in mind your normal may not be normal for another female. Some of the most common menstrual disorders include: Abnormal uterine bleeding (AUB) such as heavy periods Amenorrhea (no periods) Dysmenorrhea (painful periods) Premenstrual syndrome (PMS) Premenstrual dysphonic disorder (PMDD). Heavy Periods: One in five women have periods so heavy that it interferes with everyday activities. Heavy menstrual bleeding can be common depending on your age, especially in your teens shortly after you start menstruating and in your 50 s or shortly before you begin menopause. Heavy periods can be caused by hormonal imbalances, structural abnormalities or other medical conditions. Amenorrhea: You could also have the opposite problem in amenorrhea, or the absence of menstruation. This condition is completely normal before puberty, after menopause, and during pregnancy. Primary amenorrhea is diagnosed if you turn 16 years old and have not yet had a period. This can be caused by an issue with your hormone regulation system, low body weight associated with eating disorders, excessive exercise, or medications. Secondary amenorrhea is diagnosed if you have regular periods, but they suddenly stop for 3 or more months. This can be caused by conditions that affect estrogen levels such as stress, weight loss, exercise, or illness. Dysmenorrhea: Most women have experienced menstrual cramps at some point in their life, but when it becomes especially painful or interferes with daily activities is when it becomes dysmenorrhea. Premenstrual Syndrome (PMS): PMS is a term used to describe a variety of physical and psychological symptoms associated with menstruation. There are more than 150 documented symptoms of PMS which affect as many as 75% of women.the most common of these symptoms is depression, bloating, fatigue, headaches, and mood swings. PMS seems to be caused by rising and falling levels of hormones (estrogen and progesterone) that affect brain chemicals (serotonin and dopamine). Premenstrual Dysphonic Disorder (PMDD): PMDD is considered a severe form of PMS and is estimated that only 3-8% of women experience these symptoms. This disorder will significantly interfere with life and is characterized by increased irritability, anxiety, and mood swings. While most symptoms are associated with your period, the symptoms of depression will persist regardless of your cycle and must be treated. Consult your physician for any symptoms associated with your period that are outside of your normal or are affecting your activities of daily life. Parker, WH. Common Menstrual Disorders. 18 April Accessed from: Healthy Aging 5 OHIO NORTHERN HEALTHWISE