You’re proactive about your health, yet it’s likely you make at least some mistaken assumptions. Don’t feel bad: Until recently, many in the medical community also made them (and some still do). But thanks to long-overdue research on women’s health issues, these assumptions have been shown to be ill-informed.
“Women are more likely to have multiple chronic conditions —and be disabled by them—than men,” says Arlene Bierman, senior scientist at St. Michael’s Hospital. Many of these are preventable. Here are five:
1. Don’t assume cholesterol meds are helpful
Why it matters: Most prescription medications have been tested only in men, and one example of this is statins (a class of drugs that treat high cholesterol), says Gillian Einstein, a senior scientist at the Women’s College Hospital Research Institute and associate professor of psychology and public health at the University of Toronto. A few studies have shown lower cholesterol in women does not reduce their death rate from heart disease or their overall death rate. (Middle-aged men with heart disease do benefit from statins.) In general, medications are adjusted for differences in height and weight, but not gender, Einstein says. But “pharmacology needs to take into account how women’s bodies process a drug, and the way we shuttle drugs in and out of cells. It’s complicated and can vary with a woman’s reproductive cycle.”
What to watch for: Evidence compiled by researchers at the University of California shows that statin use in women can cause problems, including depression, extreme ’ irritability, muscle pain and weakness. And studies show women have a significantly increased rate of developing muscle weakness compared to men.
What you can do: “Women should be on guard for adverse responses,” says Einstein, and not be afraid to go back to the doctor to discuss different medications.
2. Don’t assume you ovulate every four weeks
Why it matters: If you are not trying to get pregnant, why should you care that you don’t produce an egg every month? Because research shows women who don’t ovulate regularly are experiencing hormonal dips in progesterone that could place them at increased risk for heart disease, weakened bones, and endometrial and breast cancers. “Up to one third of women experience ovulatory disturbances [do not produce an egg] even though they have perfectly regular periods,” says Jerilynn Prior, MD, a professor of endocrinology at the University of British Columbia, and the scientific director of the Center for Menstrual Cycle and Ovulation Research in Vancouver. “But there’s no need for women to panic; it’s totally reversible.”
What to watch for: Women who are not on the pill (which has synthetic estrogen and progestin) should keep close tabs on their menstrual cycle to determine if they are ovulating, says Prior. One way to tell is if you get a stretchy, clear mucous discharge that starts at mid-cycle and then goes away. Or take your temperature daily first thing in the morning for several months. Figure out the average over your cycle. If your temperature went above, and stayed above, that until the day before your period, you’ve ovulated. The higher temperatures should last 10 to 16 days.
What you can do: If you think you’re not ovulating, ask your doctor about a prescription for progesterone, which you may need to take 14 days per month to return levels to normal. Prior also recommends managing lifestyle influences that can affect ovulation, such as stress, poor diet and lack of exercise. “It’s a warning to you,” she says, adding that, in many cases, taking control of your health can restore ovulation.
3. Don’t assume osteoporosis is your biggest bone worry
Why it matters: Of course you should protect your bones against osteoporosis. However, osteoarthritis (OA)—in which joint cartilage thins, causing painful bone friction—affects more people. The likelihood that women will be disabled by it is two to three times greater than for men. The good news is pain can be managed and disability can be avoided if treated early. “The aches and pains of OA should not be seen as a normal part of aging. Even some physicians make this mistake,” says Gillian Hawker, MD, a rheumatologist at Women’s College Hospital and professor of medicine at the University of Toronto.
What to watch for: Signs of OA—tenderness, redness, swelling, heat or warmth in joints—may start as early as age 40 in the hands; in the hips and knees, it usually starts in the 50s.
What you can do: Visit your doctor to get a diagnosis. There’s no cure, but quality of life can be improved with exercise (and weight loss, if necessary), as well as pain medications and—in some cases —surgery. (Hawker says patients should not be afraid to use pain medications; they are addictive only if abused.) She adds that terrific self-management programs, critical for coping with pain, are available.
4. Don’t assume “feeling down” is a normal part of life
Why it matters: Women are twice as likely as men to experience depression, yet a multi-year research project in women’s health showed that less than half of women with depression visited a doctor for mental health care. “There’s a stigma about being depressed that often prevents women from seeking help. Also, women might not realize they are depressed,” says principal investigator Arlene Bierman. Depression is increasingly being linked with insomnia, obesity and heart disease, which greatly reduce quality of life.
What to watch for: The main symptom is a sad, despairing mood that is present for long periods on most days, lasts more than two weeks and impairs performance at work, school or in social relationships.
What you can do: Talk about your concerns with your doctor, who may suggest lifestyle strategies such as reducing stress, boosting exercise and trying talk therapy. If antidepressants are recommended, it may take some time to find one that works for you.
5. Don’t assume you aren’t at risk for heart disease
Why it matters: “We need to realize that heart disease is the leading cause of death in women,” says Bierman. Most important: Simple lifestyle changes can reduce the risk of a heart attack by 80 percent. “That’s an enormous opportunity to prevent disease and associated disability to allow women to remain active as they grow older,” she adds. Failing to take preventive measures, as well as underestimating the risk and not knowing the symptoms of heart attack, means women are less likely to seek time-critical treatment. And the misperception around its seriousness in women persists within the medical community. “We are closing the gap,” says Bierman. “But it’s just as important for women to know about their heart disease risk and what they can do to reduce it.”
What to watch for: You are at greater risk if you have high blood pressure or cholesterol, have diabetes, experience high stress, smoke, consume large amounts of alcohol and/or are inactive and overweight. You may have heard that women don’t experience the same heart attack symptoms as men, but in fact the most common symptom for both is chest pain, Bierman explains. “So women often do have the same symptoms, but are also likely to experience more symptoms that are atypical, including arm pain, vague pain, shortness of breath and fatigue [with or without chest pain].”
What you can do: Exercise, weight loss and a healthy diet will often correct high blood pressure and high cholesterol, and significantly reduce your chances of getting heart disease. Get routine checkups especially if heart disease runs in your family, and make sure your doctor tests your blood pressure, blood sugar and cholesterol.
September 2010 issue of Best Health magazine