Women’s healthcare at crossroads





By Susan Love, M.D.

Last year’s headlines on women’s health have caused a lot of confusion for many women. Mammography and breast self-exams have been called into question at a time when breast cancer continues to devastate thousands of us each year.


We’re bombarded with messages that heart disease is the biggest killer of females, yet then told that a long-used drug to combat heart disease, digoxin, may not be as safe in women as it is in men. And most surprising is that Hormone Replacement Therapy (HRT), once the mainstay of prevention for the postmenopausal woman, has now been found to cause heart attacks, strokes and breast cancer.


All this contradictory information may make it seem that scientists don’t know what they’re talking about.


In fact, it means that they finally are getting some understanding of the diseases and problems that affect women. In the past there was little or no research on women’s health; even the mice used for clinical studies were male.


Recommendations for improving women’s health were based on data extrapolated from studies on men or, in some cases, pure guesswork. In the early 1990s a critical mass of determined women demanded more research. And the current crop of studies are the first fruits of that effort.


Although this new era of science will ultimately benefit all women, some of us need to make decisions right now. Should you stop the hormones you’ve been taking for years to combat the effects of menopause? If under age 50, should you still have mammograms?


The stock answer to all of these questions has always been that you should talk to your doctor.


But doctors are busy these days and often don’t have as much time to devote to patient education as they’d like. We have to take some responsibility for educating ourselves. This means doing our own research.


Books and Websites are valuable and many are disease-specific. As with all sources of information, make sure you know where the information is coming from and what potential biases it might have.


Nonprofit organizations can be very helpful with information and often can connect you with women who have experience with a specific condition. And, surprise, even your health plan can be a source of accurate advice.


PacifiCare has a comprehensive program, Women’s Health Solutions, which includes information in print and on the Web covering everything from pregnancy to menopause and heart disease. Kaiser Permanente also has a good Website for its members with lots of information.


What’s important is that you identify a trusted source to help you understand the issues that are relevant to you and your family.


This is just the beginning of the age of women’s health. There’s a lot more information to come in the next few years.


Some of the "truths" we hold today will change in the years ahead as ongoing clinical trials are completed and further analysis is performed.


An example is the recent news that a vaccine has proven successful in preliminary clinical trials for the viral strain responsible for about half the cases of cervical cancer.


Once the clinical trial data is completed, our views and recommendations regarding Pap smears will undoubtedly change.


It’s critical that women become as savvy in their consumption of healthcare for themselves and their families as they are in every other area of their lives. This is no longer something we can leave to the professionals alone; we need to become partners in our own health. For more information about these and other women’s health issues, visit www.SusanLoveMD.org.


Dr. Love is author and medical director of the Susan Love, M.D. Breast Cancer Foundation.



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