women’s health

RECENT POSTS

May 1, 2012 | 4:12 PM | By

The Menopause Map: New Guide For Navigating The Post-Fertility Life

(pennstatelive/flickr)

If you’re female and middle-aged, there are certain things you know: hormones for menopause used to be good, then they were bad, now they’re, well, better, but not great, depending on your health profile.

Isn’t menopause challenging enough without such conflicting, confusing information swirling around?

The folks behind a new, interactive tool called the “Menopause Map” hope to add clarity — particularly on the issue of hormone therapy — to our murky, post-fertile existence.

By answering personal questions related to menopause, you take a “journey” through the Map’s menu options and wind up with some tailored answers. (For instance, when I answered “No” to the question of whether I was considering hormone therapy, I got sent to a page with the heading: “If I Decide on Non-Hormonal Options, What Are My Choices?” where I could search “proven therapies,” “unproven therapies” and “lifestyle changes.”) Users are then advised to print out their answers and take them along to the doctor.

Beyond the map, the site includes a ton of research and physician-vetted articles on menopause-related topics, from bioidentical hormones and complementary and alternative treatments, to the pros and cons of hormone therapy and doctor surveys on medical management to recipes for Moroccan Vegetable Stew and Central American Coleslaw.

The Menopause Map is managed by the Endocrine Society, which bills itself as “the world’s oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology.” Not surprisingly, then, you can easily find the endocrinologist nearest you by simply typing in your zip code. Continue reading →

FILED UNDER: Medicine/Science, Personal Health, hormone therapy, menopause, women's health
April 20, 2012 | 6:00 AM | By

Behind Breastfeeding Victory: ‘Motherhood And Career Collided’

Sophie Currier and Lea

Sophie Currier and her daughter Lea, now almost five. (Photo courtesy of Ali Smith, from her upcoming book, "Momma Love: How the Mother Half Lives," http://alismith.com/blog/category/momma-love).

In 2007, when Dr. Sophie Currier’s daughter, Lea, was four months old and still exclusively breast-fed, Sophie requested extra break time during an all-day medical licensing exam to pump her breasts. The test’s overseers, the National Board of Medical Examiners, said no, that breastfeeding was not federally recognized as a legal disability and therefore could not be accommodated.

Sophie, who has an MD and PhD from Harvard, fought that decision, and just last Friday the Massachusetts Supreme Judicial Court ruled in her favor, citing “barriers” to breastfeeding and saying the medical board did indeed have to give nursing mothers extra break time to express milk. Since only women breastfeed, the issue is one of gender discrimination, the court found.

Though the decision was narrowly oriented toward Sophie’s specific case, it “potentially impacts any testing organization that administers these types of professional exams,” said Sophie’s pro-bono lawyer, Marisa Pizzi of the firm Bowditch and Dewey. “The court was very clear that we’re talking about a lengthy exam, in this case one that extends nine hours. So any professional exam that takes course over such a long period of time could potentially be subject to these new protections.”

For Sophie, now 38, the classic career-family crunch time of life has included the added complication of a major lawsuit. She now lives in London with her husband and two children, has passed the British medical licensing exam and is planning to run the 26-mile London Marathon on Sunday. The lawsuit has been a nearly five-year journey for her, and though she won, she has also paid a personal price. We spoke by phone; our conversation, edited and distilled:

Your lawsuit turned into a long fight for you. What made you step into this fray?

I might be overly idealistic, but I believe very strongly that you cannot make progress and improve the world if you’re just going through the motions and taking whatever injustice comes your way. I believe fundamentally that if we don’t stand up against injustice, civilization falls apart. I would not have birth control or be a physician scientist if other women had not stood up for justice in the past.

How did the board’s denial and the lawsuit affect your career? Did you feel as if you were penalized?

The scientific way to look at it is that before the lawsuit, I had gotten into a very prestigious residency program. All the programs I applied to in 2006 and early 2007 had called and told me I was a top candidate in pathology, and I got my first choice of programs.

After the lawsuit, I applied two more times to about 30 residency training programs. Despite later getting a strong score on the exam in question, I got two interviews and one acceptance. Unfortunately, this acceptance was in a location that was not possible for my family.

So you were effectively blackballed? Continue reading →

FILED UNDER: Medicine/Science, Personal Health, breastfeeding, women's health
March 1, 2012 | 2:04 PM | By

Blunt Amendment Dead In Senate, Political Jockeying Alive And Well

(Mark Sardella/flickr)

The so-called Blunt amendment, which would have allowed employers to opt out of health care coverage they found objectionable — i.e., birth control for women — was voted down in the Senate 51-48, The New York Times reports.

But U.S. Sen. Scott Brown’s support for the amendment has become grist for the political mill, with flying press releases, outraged advocates and chest-thumping about religious freedom and morality all around. Here’s a sample of reaction we’ve received:

Planned Parenthood reacted swiftly with this:

Planned Parenthood League of Massachusetts (PPLM) expressed disappointment over Senator Scott Brown’s vote today for the overreaching Blunt Amendment that seeks to deny individuals access to essential health care. This measure would allow any employer or health plan to deny any health care service they find objectionable. It takes refusal for basic health care well beyond birth control – an employer could deny access to in-vitro fertilization, HIV/AIDS treatment, and other essential health care services.

“The reality is that the Blunt Amendment undermines fundamental tenets of the Affordable Care Act and the integrity of our nation’s health care system,” said Dianne Luby, President/CEO of PPLM. “We’re very disappointed that Senator Brown supported this attack on basic health care access. Then again, he did campaign in 2010 on promises to be the critical vote to defeat health care reform.”

Scott Brown’s office released this:

U.S. Senator Scott Brown (R-MA) issued the following statement after voting for the Blunt Amendment to protect religious freedom and allow a conscience exemption in health care for people of faith: Continue reading →

FILED UNDER: Medicine/Science, Politics, blunt amendment, contraception, elizabeth warren, scott brown, women's health
December 13, 2011 | 9:43 AM | By

Study Finds Working Moms Multi-Task More. Duh.

As every working mother I know would say, in unison: “You needed a study for this???”

But yes, new research, published in the December 1 issue of American Sociological Review and titled “Revisiting the Gender Gap in Time-Use Patterns: Multitasking and Well-Being Among Mothers and Fathers in Dual-Earner Families,” has found that moms with jobs outside the home do more juggling than dads.

This morning, as I was making my kids’ lunches, fixing the typos in our blog’s daily roundup, imagining the choreography I’ve promised for a family opera I’m performing in, taking pictures of my kindergartner’s pajama day at school and preparing to talk about sexual anorexia on the radio later today, I thought my brain might explode. Continue reading →

FILED UNDER: Personal Health, gender, multitasking, sociology, women's health, working moms
December 1, 2011 | 10:21 AM | By

The Yoga Effect: When Older Women Overestimate Their Fertility

Has yoga and better health made older women ignore their biological clocks?

The storyline in a bunch of recent articles suggests that older women have become somewhat delusional about their ability to get pregnant, wrongly assuming that good health and sexy biceps can trump the hard deadline imposed by their own biological clocks. Blame it on yoga, among other culprits, which makes us look and feel younger and helps us harbor illusions of nearly eternal fertility.

The most recent piece — based on a survey sponsored by the drug maker EMD Serono — ran on NPR today.

It found that women seem to be clueless that getting pregnant after 30 or 35 can be extremely tough and rife with complications (which, incidentally, is the title of The New Yorker article written a few years back by the late feminist playwright Wendy Wasserstein about giving birth to a daughter at age 48. An excellent new biography of Wasserstein, by former Wall Street Journal reporter Julie Salamon, offers additional sad and chilling details about Wasserstein’s secretive pregnancy, her death at age 55 and the little girl, Lucy Jane, she left behind. Just to be clear, the yoga effect did not play into Wasserstein’s late-in-life pregnancy — other forces were at work. Read the book.)

Here’s a bit of the NPR piece:

The fastest-growing rates of childbearing are for those 40 and older. Continue reading →

FILED UNDER: Personal Health, fertility, pregnancy, women's health
November 11, 2011 | 9:14 AM | By

What Went Wrong With Vaginal Mesh: The Podcast

Radio Boston ran a short piece on the problems with vaginal mesh earlier this week, but a key voice didn’t make the final cut: Dr. Anne Weber, a urogynecologist, formerly with the NIH, was the lead author of a clinical practice bulletin on pelvic organ prolapse published by the influential professional group, the American College of Obstetricians and Gynecologists.

In the bulletin, published back in 2007 Dr. Weber used the word “experimental” to describe a type of surgery in which synthetic mesh is implanted vaginally to repair prolapse, a condition many women face after childbirth and as they age in which tissues become stretched and weakened and pelvic organs, such as the bladder, can sag or bulge into the vagina. Seven months after the original bulletin was published, it was pulled, and replaced with another bulletin on prolapse, this one with the word “experimental” gone.

Dr. Weber says the revision, which she opposed, was based on some doctors’ fear that insurers would not cover a procedure deemed experimental. “I think ACOG was choosing to protect its clinicians’ insurance incomes over patients’ well being,” she told me in an interview.

You can read more about the controversy, and about why vaginal mesh surgery is now under scrutiny, here.

So, for the record, here’s the full Radio Boston segment, with Dr. Weber’s comments included.

Vaginal Mesh: November 11, 2011
FILED UNDER: Insurance, Medicine/Science, Money, Personal Health, below the waist, prolapse, surgery, urogynecology, vaginal mesh, women's health
November 4, 2011 | 1:46 PM | By

Surgery Under Scrutiny: What Went Wrong With Vaginal Mesh

On a rainy night in early September, six women gathered for dinner at a Macaroni Grill restaurant in Gaithersburg, Maryland. They had come from around the country: Utah, Georgia, Florida, New York, Texas. But their mood wasn’t festive. All six were in town to speak publicly about their personal medical traumas in front of an advisory panel for the U.S. Food and Drug Administration.

Between them, the women figured they had undergone 45 surgical procedures to try to undo the damage resulting from vaginal surgery using synthetic mesh devices. The mesh implants were supposed to free them from the intimate discomforts that millions of women face after childbirth and as they age: pelvic organ prolapse, in which stretched, weakened tissues can allow the bladder or other organs to sag or bulge into the vagina, and stress urinary incontinence, which can lead to involuntary leakage with every laugh or cough. Once implanted, the hammock-like mesh was meant to shore up the supportive pelvic tissues and help keep sagging organs in place.

But rather than fix their problems, the mesh led to a range of far more awful complications. For some, the material eroded through the vaginal lining, causing infections and nerve damage, as well as excruciating pain, the inability to sit down or urinate without a catheter, multiple hospitalizations and a halt to their sex lives.

“I was in the most horrendous pain I’ve ever experienced,” said Amy Gezon, a 43-year-old mother of three and one of the women who testified before the FDA advisory panel. “I finally ended up in the ER after expressing a desire to end my life just to escape the pain. If I knew one-tenth of the information out there in the literature…I would have never consented to this surgery.”

A Higher-Risk Device

The FDA, which has already detailed the serious complications linked to vaginal mesh surgery in a series of public health alerts – one in 2008 and an update this summer – is now considering reclassifying some of the devices into a higher-risk category that would require more evidence of safety and effectiveness, including clinical studies. Continue reading →

FILED UNDER: Insurance, Medicine/Science, Money, Personal Health, below the waist, fda, special report, urogynecology, vaginal mesh, women's health
November 2, 2011 | 11:10 AM | By

Latest Vitamin D Study: Little Effect In Older Women; Body Fat May Be Key

Dr. Charles Eaton of Brown University

I agree absolutely with all the people who denounce health coverage as an endlessly flip-flopping see-saw going back and forth between “Eat more X,” and “Don’t eat X.” Drink wine. No, don’t. Fat is bad. No, carbs are bad. Vitamins are good for you. No, they may be bad. I could go on.

But such is the nature of the kind of epidemiological research that yields many of the findings that are translated into health recommendations. It’s messy, complex, difficult work that tries to lurch toward some kind of consensus, and we follow its results like the audience at a baseball game, seeing the score at the end of each inning but not knowing what the final count will be.

All of which is a long-winded preamble to the fact that I published this post about a prime proponent of Vitamin D last week, and now would like to pass along new findings by researchers from Brown University and elsewhere that are less enthusiastic about Vitamin D’s potential broad health effects.

From Brown:

“A study of postmenopausal women found no significant mortality benefit from vitamin D after controlling for health risk factors such as abdominal obesity. The only exception was that thin-waisted women with low vitamin D levels might face some risk. The results, based on data in the Women’s Health Initiative and published online in the American Journal of Clinical Nutrition, agree with advice issued last year by the Institute of Medicine that cautioned against vitamin D having a benefit beyond bone health.”

The press release, which is here, begins:

PROVIDENCE, R.I. [Brown University] — Doctors agree that vitamin D promotes bone health, but a belief that it can also prevent cancer, cardiovascular disease and other causes of death has been a major health controversy. Continue reading →

FILED UNDER: Medicine/Science, Personal Health, cancer, heart disease, vitamin D, women's health
October 7, 2011 | 4:52 PM | By

11 Ways To Lower The C-Section Rate (Your Suggestions Included)

Everyone’s been through it. But for some reason, the topic of childbirth seems to get people awfully riled up.

Readers responded passionately to a story we posted earlier this week about the rate of cesarean deliveries in the U.S. creeping up to 50 percent. The comments section included some intense back-and-forth on how to fix things.

So here are 11 suggestions for lowering the c-section rate. The first six come from John Queenan, an emeritus professor at Georgetown University’s department of obstetrics and gynecology and author of a recent editorial on the topic in the medical journal Obstetrics and Gynecology. The last batch are from readers.

1. Get a commitment from hospital obstetric departments to work on lowering the C-section rate and also cut down on the number of drug-based labor inductions. (See this related post on pregnant women inducing their own labor.) Continue reading →

FILED UNDER: Medicine/Science, Personal Health, cesarean delivery, childbirth, women's health
September 26, 2011 | 12:32 PM | By

Did ‘Our Bodies Ourselves’ Change Your Life?


One after another, the women of all ages came to the audience microphone and instead of discussing the film they’d just seen, they paid homage and offered heartfelt thanks to Judy Norsigian for a book that changed their lives.

At least, that’s my memory from a screening and panel discussion I attended a few months ago — and the film was quite a provocative one, too. It’s just that women whose eyes have been opened by Our Bodies, Ourselves, which is written by a collective that Judy helped found, tend to feel a burning sense of gratitude — and this was a rare chance to express it.

This weekend offers another chance: A celebration and conference on global women’s health at Boston University, marking the iconic book’s 40th anniversary and the release of its latest version. I see from the Website that the event is already full, but there’s a waiting list and it will be Webcast here.

Readers, did Our Bodies Ourselves change your life? Let us know how, below (and you can email your account to the book’s blog, as well, here.) I’d share more if my own memory weren’t such a sieve, but my recollection is that it was my most important source of information about sex and my own anatomy when I was a teenager and beyond.

Radio Boston aims to air a segment with Judy Norsigian sometime soon, and USA Today does a wonderful job today of summing up the era that spawned OBOS, as it’s widely known, and the book’s sweeping impact. It also shares the disturbing news that the OBOS collective is ever on the verge of going under, and now is no exception:

More than 4 million copies of the book have been sold; an additional 300,000 have been donated to women’s groups worldwide. It has been published in more than 20 languages and updated in nine incarnations, yet the collective struggles, Norsigian says.

“We’re always on the edge of going under,” she says. “Part of the problem is we have all these principles — we won’t take drug company money, or advertising, plus we’re about raising consciousness. … We’re too radical for some funders and not radical enough for others. We’re facing possibly going under next year.”

FILED UNDER: Medicine/Science, Money, Personal Health, below the waist, our bodies ourselves, women's health