Women s Health Authors: Alexis Dolin, Andrew Duska, Hannah Lamb, Eric Miller, Pharm D Candidates 2018 May 2018 Let Your Body Empower You! National Women s Health Week Polycystic Ovary Syndrome Page 2 Breast and Ovarian Cancer Page 3 Page 4 Osteoporosis Page 5 Did you know that 13.3% of women in the United States over the age of 18 are considered to have fair or poor health? Well, May 13th marks the start of National Women s Health Week this year, and what better time to begin monitoring your wellbeing as a woman than during a week created just for you! Use this time to stay up to date on the important topics that affect you most. Your health and wellness is essential and should not be overlooked or forgotten. This newsletter covers five significant disease states that women may encounter throughout their lifetime and includes tips on how to prevent, monitor, and treat them. Continue reading for more information on how you can play a role in maintaining your own wellbeing! Women s Health Statistics, CDC
Polycystic Ovary Syndrome Polycystic ovary syndrome (PCOS) is a hormone imbalance that can cause complications with the ovaries. It is one of the most common and treatable causes of infertility. While there is a chance that cysts may form on the ovaries, many women do not develop this symptom. Instead, more common symptoms associated with PCOS that women may experience include: Irregular menstrual cycle and Infertility Unwanted hair growth (hirsutism) Thinning of hair on head Acne Weight gain Fatigue Mood Changes The exact cause of PCOS is unknown, but may be due to multiple hormonal imbalances. The hormones involved in PCOS include: Androgens: male hormones are made in all females to some extent. It is believed that women with PCOS make more androgens, which are responsible for many symptoms including acne, hair problems, and irregular menstrual cycles. Insulin: Women develop insulin resistance with PCOS, meaning their body cannot use the insulin they make as efficiently to absorb sugar into the cells for energy. The body tries to make more insulin to overcome the resistance and the excess insulin can cause the body to make more androgens. The health risks associated with PCOS can include the risk of infertility. Furthermore, over half of women with PCOS will develop diabetes or pre-diabetes before the age of 40. Other complications include high blood pressure, unhealthy cholesterol, sleep apnea, depression, anxiety, and endometrial cancer. This is why it is important for women with these symptoms to visit their doctor. Who is at Risk? The risk of developing PCOS is higher in women who are obese or those who have a mother, sister, or aunt with a diagnosis of PCOS. If you have questions or concerns regarding PCOS, consider making an appointment with your doctor or talking to a pharmacist. Diagnosing and Treatment There is no specific test to diagnose PCOS. Most doctors will review symptoms, perform a physical exam, and review lab work prior to the diagnosis. Unfortunately there is no cure for PCOS, but there are multiple strategies that can be used to control the symptoms. Lifestyle changes for weight loss can be beneficial in making the menstrual cycle more regular and reduce the risk of associated complications. While it may be difficult to lose and keep off weight with this disease state, patients are encouraged to lose 5-10% of their body weight. For example, a woman who weighs 200 pounds should set a goal to lose 10-20 pounds. There are also a few prescription medications that the doctor may want to discuss. These include: Birth Control Combined hormonal birth control pills may be prescribed for women who do not wish to become pregnant. This may help regulate the menstrual cycle and reduce unwanted hair growth and acne by decreasing androgen levels. It will also help protect the lining of the uterus to reduce the risk of endometrial cancer. Metformin Metformin is a medication that is commonly used for patients with diabetes to make the body more sensitive to insulin. It can help to lower high blood sugar, insulin and androgen levels, which may result in improved menstrual cycles and some weight loss. PCOS and Pregnancy Women with PCOS who wish to become pregnant may improve their chances of getting pregnant through lifestyle changes alone. For those who are still unable to get pregnant, your doctor may discuss medications that increase fertility or in vitro fertilization (IVF). PCOS, U.S. Department of Health and Human Services; PCOS Information, PCOS Awareness Association; What is PCOS, PCOS Challenge, Inc; PCOS Frequently Asked Questions,The American College of Obstetricians and Gynecologists. Women s Health 2
Breast and Ovarian Cancer Cancer is a disease in which the cells of your body grow abnormally with the potential for spreading. If these cells begin to accumulate in the breast or in the ovaries, it is called breast and ovarian cancer. Although these cancers are more commonly seen in older women, both can develop in younger females as well. In these younger women, the cause of the cancer is most often hereditary and occurs when a gene known as the breast cancer susceptibility (BRCA) gene, becomes mutated and is passed down from parents to their children. Who s At Risk? Breast Cancer Risk Factors: First menstrual period before age 12 Late menopause (after age 55) Having first child after age 35 Never giving birth Long-term use of birth control (5 years or more) Family history or past history of breast cancer Being overweight Drinking alcohol (more than 1 drink a day) Not getting regular exercise Ovarian Cancer Risk Factors: Reached or are past middle age Being overweight Never given birth or had trouble getting pregnant Family history or past history of ovarian cancer Past history of breast, uterine, or cervical cancer Past history of uterine tissue growing outside the uterus à Even if you have one or more of these risk factors, that does not mean you have cancer. Talk to your doctor or pharmacist about ways in which you can reduce your risk developing these. Signs and Symptoms Breast Cancer Symptoms: New lump in the breast or armpit region Thickening or swelling of part of the breast Irritation or dimpling of breast skin Redness or flaky skin in the nipple area or the breast Pulling in of the nipple or pain in the nipple area Nipple discharge other than breast milk, including blood Any change in the size or the shape of the breast Pain in any area of the breast Ovarian Cancer Symptoms: Abnormal vaginal bleeding or discharge Pain in the pelvic, lower abdominal area, back pain Bloating Urgent and frequent constipation, diarrhea, or urination àquick FACTS 1 in 8 women will develop breast cancer in her lifetime 1 in 75 women will be develop ovarian cancer in her lifetime Ovarian cancer causes more deaths than any other cancer of the female reproductive system 89% of breast cancers occur in women over the ages of 45, however they can occur in women younger than this Prevention and Monitoring Every woman s body is different, so it s important to know your own body and what s normal for you! You can play a role in monitoring your own health. Here s how: 1. Exercise for at least 30 minutes, 4 days a week 2. Incorporate more vitamin A, vitamin D, vitamin E, foods low in fat, fiber, fruits, and vegetables into your diet 3. Cut back on alcohol consumption to 1 drink per day maximum or eliminate it entirely 4. Stop smoking 5. If you have a family history of breast or ovarian cancer, genetic testing may be an option for you VISIT WWW.BRIGHTPINK.ORG TODAY to learn more about how you can take action, assess your risk, and put your health first! Take Action, Bright Pink; KnowBRCA, CDC and Bright Pink Women s Health 3
is a natural and normal part of life for a woman, defined by 12 consecutive months without having a period. Typically this occurs around age 50, but can be experienced earlier or later in life. It is caused when the ovaries stop producing estrogen, which is the hormone that regulates the menstrual cycle. What are some common signs and symptoms of menopause? Periods will become irregular or stop. You may experience hot flashes and/or night sweats. Vaginal dryness, decreased libido, or mood swings including depression, anxiety, and irritability may affect you. You might notice you are having difficulty sleeping or even experiencing some changes in weight or thinning of the hair. Examples of Hormone Replacement Therapy Symptom Treatment Options Treatment of symptoms during menopause depends on the severity of the symptoms being experienced. Mild Symptoms: Avoid/reduce alcohol, try benadryl as a sleep aid, or supplement with black cohosh 80 mg daily for hot flashes. Your doctor may also suggest you try Estrace, an estrogen cream, for vaginal dryness. With the reduction of estrogen during menopause, the lining of the vagina may become thinner, dryer, and less elastic. This could lead to pain during sexual intercourse. Estrace will help alleviate these symptoms. Moderate to severe symptoms: Hormone replacement therapy (HRT), which consists of systemic estrogen and sometimes progesterone as well, may be the best option. Systemic estrogen, with and without progesterone, has been shown to be the best treatment to relieve hot flashes, night sweats, and vaginal dryness. Estrogen products that get absorbed throughout your body protect against the bone loss seen in the early years of menopause, leading to decreased risk of bone fractures. à HRT use should be limited to the lowest effective dose for a maximum of 5 years Staying Healthy During Be active! Strive to get 30 minutes of exercise at least 4 days a week. Introduce vegetables and soy products into your diet. Ask your doctor about calcium and vitamin d supplementation. Attempt to quit smoking. It is also important to practice safe sex, as you can still become pregnant during menopause. HERE S TO strong women MAY WE KNOW THEM. MAY WE BE THEM. MAY WE RAISE THEM. Top Questions about, Office of Women s Health; Treatment of the Symptoms of, J Clin Endocrinol Metab Women s Health 4
Osteoporosis Osteoporosis is a chronic condition that results from the body losing bone or not making enough of it. This leads to weakened bones and increases your risk of fractures. It can affect both men and women, but is seen most frequently in women due to the increased rate of bone loss during menopause. Your bones typically grow and get stronger from the time you are born up until your late 20s to early 30s. At this point, they are the strongest they will ever be. From that point on, they slowly get weaker as you age, with a dramatic drop off in strength during menopause. Because of this, it is important to get actively involved in your health and wellness to ensure you can keep your bones strong and healthy. Know Your Risk Factors There are many things that can put you at an increased risk for osteoporosis. Being aware of your risk factors can help you to be proactive in preventing worsening bone loss. Some risk factors include: Family history of osteoporosis Prematurely experiencing menopause Smoking or alcohol use Low calcium or low vitamin D Lack of exercise Hyperthyroidism Diabetes Hormone issues Medications including steroids, some seizure medications, and some heartburn medications Prevention The best way to treat osteoporosis is to prevent it from occurring. Some things that you can do to help prevent osteoporosis are: Ensure adequate Calcium and Vitamin D. Women require 1200 mg of calcium and 800-1000 units of vitamin D daily to help maintain bone strength. This can be from diet or from supplements. Avoid smoking or excessive alcohol. These can weaken your bones and increase your risk for osteoporosis. Partake in weight bearing exercise. 150 minutes per week of exercise on your feet can help fight off osteoporosis. Start early. The earlier in life you get active in bone health, the better off you will be. Monitor Your Bones Getting tested can help you determine your risk of osteoporosis and if there is a need for treatment. Women that should be tested include: Women over the age of 65 Women that have any risk factors for osteoporosis Women that have gone through menopause à Ask your doctor to be tested! Take Charge of Your Health! You have all the tools you need to start preventing and managing these health related problems that commonly effect women. Be familiar with your body and be proactive in making it the strongest it can be. Take the time to talk to your doctor or pharmacist about women s health. You ll thank yourself later. Osteoporosis Screening, Pharmacist s Letter; Treatment of Low Bone Density: A Clinical Practice Guideline, Ann Intern Med. Women s Health 5