What Every Woman Should Know About Health Care

Women often put their families’ health above their own, but there are many reasons why women should be ready to catch their own health problems. Learn from these doctors how to protect yourself.

A woman often holds the time-honored role of caretaker, sometimes putting the needs of her husband, children, parents, grandparents, employer and friends ahead of her own.
Logic dictates, however, that she may not be able to meet the needs of others if she doesn’t take good care of herself. Every woman should know not only the basics of a healthy lifestyle, but also when to seek a doctor’s help. Catching an impending health problem early can ensure good health today, and help to dodge serious diseases tomorrow.
One of the major risks nearly every woman faces is heart disease. The classic symptoms of heart disease and impending heart attacks in men don’t necessarily apply to women. According to the Federal Drug Administration (FDA), extreme tiredness, even after a good night’s sleep, is the most important sign that a woman may be developing heart disease. Atypical symptoms may include trouble breathing or sleeping; nausea; unexplainable feelings of fear or nervousness; new or worsening headaches; aches or heaviness in the chest; pain in the upper back between the shoulders; and pain in the abdominal area just above the belly button.
Any woman experiencing unusual pain in her chest, arms, back, neck or jaw, along with upper abdominal discomfort and/or shortness of breath, should go to a hospital emergency department immediately, since delay can make it more difficult to treat a heart attack.
Sometimes, women shrug off these symptoms in deference to their demanding lifestyles. Dr. Maria Taveras, board-certified cardiologist for Beloit Health System, warns that they do so at great peril. Furthermore, women with these symptoms shouldn’t ignore them simply because they’re young or in apparent good health.
“At Beloit Memorial Hospital, I recently treated a 25-year-old woman for an impending heart attack,” says Taveras. “Fortunately, we were able to halt it. Usually, pre-menopausal women are protected by hormonal levels. Of post-menopausal women between the ages of 45 and 64, one in nine will develop some form of cardiovascular disease. After 65, that ratio narrows to one in three. It’s a steep slope. Worse, women are more likely [than men] to die from a heart attack, and if they survive, are more likely to suffer complications. This is more so if the woman is younger than 45.”
Women not only need to know symptoms and risks of heart disease, but also that it is preventable, or at least can be substantially postponed.The FDA reports that women can lower their risk of heart disease by knowing their own family histories; abstaining from smoking; closely monitoring their blood pressure and cholesterol levels; reducing salt intake; maintaining active lifestyles; eating right; losing weight as necessary; and seeing their primary physicians regularly for tests and examinations. Women also need to reduce stress, anger and depression, as these negatively impact heart health.
Also, says Taveras, “Women should be aware of the risks involved in becoming a diabetic. About 80 percent of women who die from heart disease are also diabetic. A woman diagnosed with diabetes in her 30s is very likely to face heart disease in her 40s. Diabetes is most likely to develop when a woman’s metabolism slows and she gains weight. Don’t wait until you’re in your 40s to improve your overall health and alter your lifestyle. Start early and prevent or postpone the onset.”
Women need to know when to start worrying about their health.
“Statistically, as much as 35 percent of all women’s deaths are attributed to heart problems,” Taveras says. “Fortunately, this number has improved recently. Women must understand that, if they live through middle age, the No. 1 cause of death they face is from heart disease. It’s a natural, cumulative result of living long, but again, it can be prevented or held off.”
Doctors at Beloit Memorial Hospital follow criteria guidelines that assess heart disease risks in women. A woman aged 45 to 50 who doesn’t smoke, is not diabetic, keeps her blood pressure and cholesterol under control, and has no family history of premature heart disease, falls into the low-risk category. However, with diabetes, that same woman moves into the high-risk group.
“A woman in the high-risk category faces a greater than 20-percent chance of a cardiovascular event within 10 years,” says Taveras.
As a rule, women who aren’t high risk don’t need to visit cardiologists, unless their primary care physicians recommend it. “A good physician knows where each woman patient stands, and also has prescribed the appropriate medications to help her control blood pressure, cholesterol and other influential factors,” says Taveras. “Communication between doctor and patient is vital. And that’s why it’s so important for women to not only know the warning signs and symptoms of heart disease, but also to understand how serious they might be.”
Research and major advances made in the past 20 years are steadily making heart disease in women less of a threat. “It’s amazing what’s been done,” Taveras says. “We’ve made tremendous progress. As a result of people’s increased awareness, modification of their risk factors and new technology, there’s been a steady decline in heart deaths in women since the year 2000.”

Breast Health

Every woman should also know the symptoms of breast cancer, and the importance of being screened on a consistent schedule.
Dr. Fred Church, a board-certified general surgeon with Rockford Health System’s Women’s Center, specializes in surgery of the breast and says there’s no sure way to prevent breast cancer. However, a healthy lifestyle, focused on adequate exercise, an appropriate weight level, a healthful diet and avoidance of bad habits such as smoking, drinking and drug abuse, certainly helps.
And, every woman needs to know how to conduct self-examinations beyond the search for breast lumps. “Women should watch for any changes in their breast skin, including color, dimpling and retraction,” Church says. “Check to see if there’s any change in the way the breasts are shaped. Along with checking for lumps or areas with an unusual firmness, look for bulges near the lump’s site. Examine the nipples for any crusting or bleeding, as well as a bloody discharge. Any of these signs can point to cancer, and the woman should see her doctor immediately.”
Church emphasizes the need for self-examination at least twice a month; daily exams may not detect subtle changes. “Any sudden change should be regarded as suspicious,” he says. “The best way to do self-examinations is with a soapy hand in the shower or lying flat, checking in a circular motion.”
Starting at age 40, women should schedule annual mammograms. Recent confusion about less frequent mammograms has been clarified. Women with family histories of breast cancer should have a baseline mammogram at age 25. It’s important to know if breast or ovarian cancers run in the family; women who harbor breast cancer genes BRCA1 or BRCA2 are at a dramatically increased risk of developing these cancers.
While diagnoses are increasing, survival rates are, too, a direct result of education and public awareness.
“Breast cancer is no longer a death sentence,” Church says. “While there are more cases being diagnosed, there’s less chance of it proving fatal, when it’s detected at an early stage, before spreading to lymph nodes. We can minimize the amount of tissue removed with a lumpectomy, and balance the use of chemotherapy and radiation therapy, depending on the individual case. Each woman’s prognosis depends upon the stage of her cancer, the size of the tumor, and whether or not her lymph nodes are involved. The best possible scenario is early detection and expeditious treatment.”
Today’s breast conserving surgery, or lumpectomy, not only leaves patients with better cosmetic results, but also the same cure rates and risks of recurrence that were accomplished by more radical operations of the past. Significant advances in chemo and radiation therapies have also contributed to more successful outcomes.
Church sees patients in Rockford Health System’s new Women’s Center at 7180 Spring Brook Road, where all necessary screening and diagnostic testing is not only centrally located, but also time compressed, meaning that, in most cases, same-day mammography and ultrasound results are given.
Needle core biopsies can be done quickly for rapid diagnosis, and if necessary, surgical consultation may be obtained. For those women newly diagnosed with cancer, a group consultation may be arranged with a surgeon and oncologists.
The Women’s Center recently added 3D tomographic mammography, a tool often used for high-risk patients or those with dense breast tissue. This new technology takes x-ray slices through the breast and can aid in detecting early-stage small cancers not readily seen on regular digital mammograms. In most cases, this method also eliminates the necessity of being called back for additional films.
Rockford Health System is the hospital in the region equipped to treat appropriate breast cancer patients at the time of their surgery, with one dose of radiation, in the operating room, thus eliminating the need for the usual six weeks of radiation.

Other Female Cancers

Every woman should know that cancers of the uterus, cervix and ovaries are not only biologically different from one another, but also carry vastly different risk factors. Dr. Shahid Shekhani, a board-certified medical oncologist with Mercy Walworth in Lake Geneva, Wis., says that despite their close proximity and relationship in the human reproductive system, cervical and uterine cancers are in no way the same thing.
“These are two separate types of cancers,” he emphasizes. “Cervical cancer is caused by the human papillomavirus (HPV). Because HPV is a sexually transmitted virus, it’s preventable through precautions, and now vaccination. It’s primarily the result of multiple sex partners.”
The Center for Disease Control (CDC) reports that there are more than 40 HPV types that can infect the genital areas, as well as the mouths and throats, of women and men. Most infected women don’t know they have HPV until they’re diagnosed with cervical cancer.
By contrast, “Uterine cancer may be hormonally based,” Shekhani says. “A small percentage of the population carries genes which raise the risk. For these women, a hysterectomy after they’re finished with childbearing prevents uterine cancer. Otherwise, there’s no specific way to prevent uterine cancer, although there appears to be a relationship between this cancer and a diet high in fatty foods. At this point, no major studies have been conducted to prove or disprove this connection.”
Shekhani says that while uterine and cervical cancers are different from each other, symptoms can overlap. Women should be especially concerned about spotting or bleeding between periods and after menopause.
“Usually, there’s no pain associated with these cancers in the early stages because they occur in soft tissue,” he explains.
Consistent testing is one way to catch cervical cancer early.
“Every woman is different, but based on risk factors, they should have a PAP test every one to three years, based on past results,” he says. “There are two different types of PAP tests. The conventional PAP, and the more recent liquid-based cytology tests, are both proven.”
According to the CDC, a normal PAP test result means a woman can wait for three years before scheduling her next test. An “unclear” result, however, means that cell changes within the cervix have been identified, even though the woman doesn’t have HPV present, and the PAP test should be repeated in one year. An abnormal result means that, while HPV may not be found, the woman needs further testing to assess why the result is abnormal.
“Treatment depends on the cancer’s size, location and extent of invasion into other organs,” Shekhani says. “For uterine cancers, surgical removal is the best choice if the cancer hasn’t spread. For cervical cancer, surgery, chemotherapy or radiation may be used. We custom-design the treatment for each woman, to meet her specific cancer and health conditions.”

The Payoff

Understanding and reacting appropriately to signs of impending major disease requires every woman to pay close attention to her own health; while this can be a major inconvenience, it’s a small price to pay when compared to the alternative. Taking good care of themselves may allow women to continue in their vital roles as wives, mothers, daughters, sisters and friends.

What to Know About Hormone Replacement Therapy

All women go through menopause. However, the journey is a lot rougher for some than others.
Dr. Jodi Holbrook, a board-certified OB/GYN specialist at Cornerstone Clinic, 9721 N. Alpine Road, Machesney Park, says the average age for the onset of menopause is 51, but this varies widely for individuals.
“We don’t establish that a woman is in menopause until she has not menstruated for a full year,” Holbrook explains. “The common symptoms are hot flashes, night sweats, vaginal dryness and loss of sleep. But not everyone experiences them. And not every woman needs hormone replacement therapy (HRT).”
A woman should carefully consider how greatly menopause symptoms are interfering with her lifestyle before starting HRT, says Holbrook. “When hot flashes or night sweats are occasional problems, I don’t recommend HRT,” she says. “But when a woman can’t function at work or at home because of the severity of these symptoms, then we look at ways to relieve them.”
Over-the-counter products may help ease symptoms, including Omega-3 capsules, flax seed and black cohosh. Regular exercise also helps because it can reduce stress hormones.
“At this middle age, women are constantly stressed by teenaged children, aging parents, the pressures of work and other factors,” Holbrook says. “The brain tells them they are under attack, which leads to migraine headaches, intestinal trouble, even heart attacks.”
It’s vital for women to know not only their family medical histories but risk factors involved in HRT, which increases the risk of developing blood clots, strokes and breast cancer. Many women incorrectly believe they can take hormones for a year or two, to avoid menopausal symptoms, and then stop.
“What they don’t understand is that HRT helps their bodies to continue at the same hormonal level,” Holbrook says. “When they stop HRT, their bodies pick up right where the HRT started. They have actually only postponed the symptoms.”
The emerging treatment called bio-identical hormone therapy also should be carefully considered before using. “It may sound safer but it also might not be,” Holbrook emphasizes. “Just because the body needed hormones when the woman was younger doesn’t mean it needs the exact same level of hormones later in life. Again, the risks remain the same and many insurance companies do not cover bio-identical hormone therapy.”
Menopause is a natural part of life, and Holbrook recommends as little outside influence as possible. But if HRT is chosen, she recommends starting with small doses of estrogen and or progesterone.