Women’s Health and Wellness

MPH 342 HEALTH & WELLNESS

Dr Shai’

Department of Health PNU

Week of Oct 26, 2013 Lecture 4

objectives

Identify and understand primary health issues affecting women

Risks and prevention strategies

Recommendations and homework

Overview of Women’s Issues

Leading health concerns Heart Disease-#1 Killer of women Cancer- 2nd leading cause of death Stroke- 3rd leading cause of death

Osteoporosis- Common to almost all older women

Dementia- Leading cause of nursing home placement

Menopause-A quality of life issue for 1/3 of women

Concerns of younger women: Menstrual issues, nutrition, fertility, overweight, exercise

Heart Health in Women Heart disease: Leading cause of death

What’s special about women? Women are twice as likely to die if they have a heart attack,

than a man

Women’s heart attacks are often missed/mis-diagnosed

Disproportionate % of heart attacks happen at 9 am Monday morning

Many women don’t recognize or believe they are having a heart attack

Heart attacks present differently in women- Neck, jaw or arm pain (or no pain) Panicky or uneasy feeling Shortness of breath General discomfort or tightness in chest Sweating Any of the above, exacerbated by exertion or stress

Why are heart attacks more deadly in women?

Women have smaller blood vessels with thinner walls (fragile)

Emergency room staff and medical professionals often miss the diagnosis due to unusual/mild symptoms

Women, often too busy to go to the doctor, may endure pain/discomfort in silence.

Heart Disease Prevention: ♀ Advise patients to quit smoking

Keep patient adjusted

Recommend regular physical activity

Monitor/control blood pressure & cholesterol

Manage stress effectively-yoga, relaxation techniques, biofeedback, exercise

Preventing heart disease

Heart Disease and Nutrition

Mediterranean Diet-Shown to lower risk of heart attack (More fruit, veggies, grains, less animal fat/red meat, more fish, etc.)

Whole bran foods-Oats, Wheat bran etc. (increase fiber intake)

Lower sodium intake

Vitamin E, other antioxidants, selenium

Cancers and Women

Lung Cancer Leading cause of cancer death in women

Very preventable!

Most cases are related to smoking or radon

Have home checked for radon gases

Advise pts to quit smoking Provide good smoking cessation materials

http://www.surgeongeneral.gov/tobacco/quits.htm

Breast Cancer

Breast Cancer- 200,000 cases/year & 40,000 deaths/year Risks:

Obesity, sedentary lifestyle Alcohol use High fat diet Family history (only 10% of cases) Genetics (BrCA1 and BrCA2 genes)

Red flags in breast health

Colo-Rectal Cancer

Third leading cause of cancer death

Prevention recommendations: Diet high in fiber Diet low in animal fat High calcium intake

Resources: www.cancer.org

Stroke: The 3rd Leading Cause of death in women

Risks: Smoking Overweight Sedentary lifestyle Use of oral contraceptives/hormone replacement. High blood pressure or cholesterol

Stroke: Patient Presentation

Headache or neck pain-Severe

Dizziness

Speech disturbance (may be mild or none)

Vision disturbance (may be mild or none)

Unusual weakness, numbness, etc (not injury related)

Strategies for Stroke Prevention in Chiropractic Practice

Adjusting Strategies: In patients with risk factors:

Avoid extension and rotational vectors Employ a least invasive to most invasive strategy

Do not adjust if stroke symptoms are present

Recommend Stroke Prevention For Your Patients Exercise!! Quit Smoking Increase fruits, vegetables, and whole grains Decrease animal fat and red meat Consume more fish

Osteoporosis: The “silent thief”

Osteoporosis is silent:

Often patient knows nothing about their bone loss until a fracture occurs

1/3 of women over 70 have osteoporosis

84% of women over 70 have low bone mass (osteopenia)

Osteoporosis is PREVENTABLE

Bone health

Identify who is at risk…Controllable risks Uncontrollable risks

Low calcium intake

Sedentary lifestyle

Hi caffeine intake

Alcohol use

Smoking

Soda pop drinks

European or Asian descent

Fair skinned

Small framed/low weight

Family history of OP

Early hysterectomy

Recommendations for Bone Health

Exercise: Walking or other axial loading exercises, weight lifting

Calcium Supplementation: 1,200-1,500 mg/day

Avoid smoking, caffeine, alcohol, soda pop, etc

Menopause

1/3 of women in the US are menopausal

Process starts in mid forties w/ pre-menopause

Night sweats, mood swings, depression, sexual changes.

Patients seek help!

menopause

Menopause and Health

Post menopausal increase in risks

Breast, uterine, cervical, ovarian cancer Osteoporosis Heart Disease/Stroke Dementia/memory problems

Help: Natural remedies

Isoflavones

Black Cohosh

Red Clover

DongQuai

Alfalfa

Passion Flower

Wild Yam

Especially….

Black Cohosh: <Remifemin> Used for relief of general menopausal symptoms, nervousness, anxiety, hot flashes, vaginal dryness

Resources: Whiting, Clouston, Kerlin. M J Australia 2002;177(8):440-443.

Leiberman: J Women’s Health 1998;7(5):525-529.

What herbs for what?

Herbs For Bone Loss:

Wild Yam: natural progesterone source

Chaste Berry-LH/Progesterone stimulant

Red Clover: All 4 isoflavones Daidzen, Genistein, Formononetin, Biochanin

Source: Nestel et al. J Clin Endocrinol Metab. 1999; 84(3):895-8.

On your own…

What is the incidence and prevalence of breast cancer in the Kingdom?

What are the commonest types of breast cancer?

Who is most at risk for breast cancer?

Why is mammography so important?

What can a woman do to protect herself against breast cancer?