Five Top Health Concerns for Women

Women have always worried about certain problems—breast cancer, ovarian cancer, obesity and even depression. But as the years go by, doctors and patients are learning more and finding other problems that are not as well known.

In the last several decades, the field of medicine has made great strides in the way women receive their healthcare. Following are five of the top health concerns of women.

Heart Disease

Women's Heart Health at Scott & White
It is the number one killer of women in the United States, but many women, and even a few doctors, overlook the seriousness of heart disease symptoms in women.

“Women are more likely to have atypical symptoms. This, combined with the fact that women are more prone to have other illnesses at the same time they develop heart disease, lends itself toward the underdiagnosis of heart disease,” said Margaret Happel, M.D., Scott & White cardiologist.

The high death rate is startling enough, but what is even more serious is the number of women who are left disabled by heart disease and stroke. Even though more men than women die of the disease, thousands of women suffer from the effects of heart disease, such as shortness of breath and chest pain. Symptoms of heart disease include chest pain, jaw pain, shoulder ache, nausea, vomiting and shortness of breath.

“Symptoms such as these should prompt immediate medical attention,” Dr. Happel added. “If a woman is concerned about the possibility of having heart disease, I would advise her to make a list of questions to discuss with her doctor regarding both her symptoms and specific risk factors and then formulate how both she and her doctor can best address these symptoms and risk factors.”

Taking a leading role in raising awareness of the increased risk of heart disease in women, Scott & White participated in the national “Go Red for Women” heart disease campaign, sponsored by the American Heart Association. With community-wide seminars and screenings, Scott & White was involved in the effort to help more women understand their risks and stay heart-healthy.

Breast Cancer

Women's Breast Health at Scott & White
Although it might not claim as many lives as heart disease, breast cancer is often the most feared disease of women because of the effects it has on their bodies and their lives. Breast cancer is the second leading cause of cancer deaths in women today, behind lung cancer.

Many doctors say that fears about breast cancer can sometimes stop women from going in for their annual mammogram—a procedure that can literally save lives. All experts stress the importance of regular mammograms.

“The incidence of breast cancer continues to rise, especially in postmenopausal women,” said Darlene Miltenburg, M.D., Scott & White breast cancer surgeon. “However, we are now able to treat breast cancer with less-invasive techniques. For instance, at least half of all breast cancers can be treated with a lumpectomy instead of mastectomy. We are now able to remove one or two lymph nodes in the underarm instead of all of the lymph nodes. And, in some women, we can complete their radiation in five days, instead of 30 days.”

Scott & White is one of a handful of hospitals nationwide—and the only teaching hospital in Central Texas—offering the Mammosite® Radiation Therapy System for the treatment of early-stage breast cancer. This treatment, which reduces radiation treatment time from six weeks to five days, allows more women to keep their breasts while still effectively treating the cancer. In addition to new procedures and research, Scott & White has a comprehensive breast cancer team that uses a multidisciplinary approach involving oncologists, surgeons, radiologists, social workers, nurses, plastic surgeons, chaplains, pathologists and geneticists.

Osteoporosis

Osteoporosis Treatment at Scott & White
Osteoporosis is a preventable disease and yet, according to the National Institutes of Arthritis and Musculoskeletal and Skin Diseases, 44 million Americans, 68 percent of whom are women, are at high risk for fracture because of this damaging disease. “Even though fractures may not be seen until late in life, the importance of promoting bone health in children, and continuing the process throughout life, is vital,” said Veronica Piziak, M.D., Ph.D., Chief of Endocrinology at Scott & White.

Important risk factors for osteoporosis include the following:

• Small frame
• Older age
• Diet low in calcium and vitamin D
• Smoking
• Excessive alcohol use
• Steroid use

This year, the first report published on bone health and osteoporosis from the surgeon general shows that progress has been made in bone health in the last few decades, but much more needs to be done. According to the findings, physical activity and adequate calcium and vitamin D intake are major contributors to bone health for everyone. Children should be encouraged to exercise and to include calcium and Vitamin D in their diet. The report states that new diagnostic tools, research and therapeutic advances have helped raise awareness of the importance of focusing on bone health.

A determination of bone density can be used to identify people at risk for fracture and those people who have osteoporosis. Within the last 10 to 15 years, new classes of drugs that decrease bone destruction and stimulate bone growth have been developed and have significantly reduced the risks of fracture in people with osteoporosis.

Research is helping to identify additional drugs and therapies that will prevent fractures. At Scott & White researchers are conducting several studies involving drugs that are known to improve bone health and that possibly can prevent fractures. Many people with osteoporosis cannot tolerate effective medications taken orally, and Scott & White researchers are looking at two drugs that will eliminate that problem.

“It is only because of the help of the many people who volunteer to participate in our studies that we can find medicines that will help the millions of people with osteoporosis,” said Dr. Piziak

Currently, Scott & White is actively recruiting for a study. If you are interested in participating, you may contact Robin Cameron at 254-724-6642 or Becky Olson at 254-724-5678.

Depression

Mental Health Services at Scott & White
Depression is one of those disorders that few people like to talk about but more people cope with than anyone really knows. For women in particular, it is a significant problem. In fact, about 12 million women are affected by a depressive disorder each year, according to the National Institute of Mental Health, and the World Health Organization ranks depression as the most disabling condition in the world among working-age adults.

“Twenty-five percent of women and 12 percent of men will have one or more episodes of depression in their lifetime,” said Randall Moore, M.D., a Scott & White psychiatrist. Risk factors for depression include family history of depression, history of heart problems, chronic illness, marital problems, substance abuse or being a worrier or overly anxious. “There are different degrees of depression. Some people have episodes of depression that resolve themselves with time. Others can feel their depression deepening until they are unable to resolve their problems themselves. These people are often diagnosed with major depression,” Dr. Moore said.

In women, depression is often associated with pregnancy and childbirth. “Postpartum depression” is a common phrase these days. According to Dr. Moore, the prevalence of serious depression is about 17 percent in late pregnancy, and after giving birth, 30 to 85 percent of women experience the “baby blues.”

Usually this type of depression is resolved with supportive treatment. “Many cases of depression are related to chronic life stresses,” Dr. Moore added. “How a person perceives a stressful problem may be as important as the nature of the stress itself. Pregnancy and childbirth obviously are life-changing events for a woman and can affect her personality.

Hormonal changes in her body also play a role and can make a woman more susceptible to stress and depression.” According to Dr. Moore, if a person is concerned that he or she may be depressed, the first step is to see the primary care physician, who can then make the decision as to whether the patient should be referred to a psychiatrist.

At Scott & White, physicians can refer patients to the Mental Health facility, where patients can see either a licensed psychotherapist or a psychiatrist to develop a treatment plan, which may include psychotherapy, medication or exercise and nutrition plans.

Diet and Nutrition

One of the biggest concerns for women is their weight. A world of ultra-thin models and unrealistic weight goals has contributed to increasing numbers of anorexic and bulimic women, but another side of the weight issue has claimed more attention lately—obesity.

According to experts at the Centers for Disease Control, obesity has reached epidemic proportions and the future looks even worse. A study conducted by the CDC showed that 31 percent of adults are obese and 15 percent of children and teenagers aged 6–19 are overweight.

What is obesity? Obesity means having too much body fat and is determined by a person’s body mass index, or BMI, which measures weight in relation to height. A person’s BMI is calculated by a formula established by the National Institutes of Health. Weight (in pounds) divided by height (in inches) squared and multiplied by 703 equals BMI. For example, a person who weighs 180 pounds and is five feet four inches tall would have a BMI of 30.89. An adult with a BMI of 30 or higher is considered obese and is at risk for health problems such as diabetes, heart disease and stroke.

Many different factors can lead a person to gain weight and become obese. “The typical American woman is relying on fast food as a staple for herself and her family and does not make exercise a priority in her busy schedule,” said Dawn Sears, Scott & White gastroenterologist. “Obesity-related liver disease is the most common reason I see people in the ‘liver clinic’ and will be the number one reason for liver transplant in the next 10 to 15 years.”

Solutions for people who are obese include a variety of diets and even surgery, but many doctors recommend a combination of two important strategies.

“Comprehensive lifestyle management, which includes healthy eating and exercise, is integral to losing weight, keeping it off and being healthier,” said Lynn McLellan, R.D. “It's a simple fact that muscle burns more calories than fat, so the more lean muscle you have, the more efficiently you will burn calories. Conversely, someone with a high percentage of body fat will have difficulty burning off any extra calories consumed.

At Scott & White, we help people find foods that are healthy and satisfying to them, while also helping them find an exercise plan that fits their needs.” For a free weight-loss and personal-exercise plan, visit www.swhp.org and click on “Lifestyle Management Programs.”

In addition to the diseases discussed here, there are many other ailments that plague women and cause concern about the future. But there is good news! Men and women are living longer, healthier lives than ever before. Thanks to technology, preventive medicine, and specially trained physicians and researchers, people can take steps throughout their lives to prevent many of these conditions from becoming problems for them.

Whether it’s changing your diet to reduce your risk of heart disease, making sure you do breast self-exams if you have a family history of breast cancer, or taking steps to keep your mind as sound as your body to stave off depression, you can take charge of your life and of your body, and the result will be a longer, happier life.

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