'Women's Health' posts

Symptoms associated with menopause have been treated with estrogen and progesterone for many years. When I went into private practice in 1986, we had been taught that hormones given to postmenopausal women were protective. We prescribed them widely, like they were vitamins. If menses stopped, the next thing to do was to take hormone replacement therapy. We asked patients to let us know when their menses stopped so that we could administer hormone therapy promptly.

Today we have concerns about hormone therapy. The Women’s Health Initiative was a large study that collected data on the incidence of heart disease, stroke, cancer and bone fracture in women taking hormones as compared with women who did not take hormones in menopause. In 2002, a large portion of the study was discontinued because it appeared that women taking estrogen and progesterone were at increased risk for heart disease, stroke and breast cancer.

In 2002 many women went off of hormone therapy and many physicians stopped prescribing it. In the months that followed, many women found that they had symptoms of menopause that interfered with their lives. The consumer media began reporting on natural and bio-identical hormones. Claims surfaced of superior safety.

What are natural hormones?

Recent changes to Pap guidelines may have you wondering when exactly you need to have a pap smear and in turn, how often you really need an annual exam with your gynecologist. Here I’m going to review the new pap guidelines so you can determine if you are up to date! Of course, every patient should check with their physician about what they recommend regarding the timing of cervical cancer screening because some specific populations may have different recommendations. These are just the general guidelines.

Pap smears are a screening test for cervical cancer. They have helped decrease the incidence of cervical cancer by more than 50% in the last 30 years. Over the last decade we’ve also begun testing for HPV (or Human Papillomavirus) which is by far the most common cause of abnormal pap smears and cervical cancer. It is an incredibly common sexually transmitted virus that can be spread by genital to genital contact but also oral to genital and manual to genital contact. It has been estimated that 75 to 80 percent of sexually active adults will acquire a genital tract HPV infection before the age of 50. Luckily, most HPV-infected women, especially younger women, will mount an effective immune response to the virus and will never develop dysplasia or cancer.

HPV is not like herpes —YOU CAN GET RID OF IT! The amount of time it takes to get rid of the virus varies but most experts think it takes an average of 8-24 months. Women with persistent HPV infections are more likely to get dysplasia and if it goes undetected or untreated, over time it can develop into cancer. HPV infections of the cervix do not cause symptoms and can only be detected by pap screening. Unfortunately we don’t have a cure for HPV, but vaccinations are available and FDA approved for girls and now boys ages 9-26. More on HPV is sure to show up in future blog posts, so stay tuned!

The American College of Obstetrics and Gynecology (ACOG) recommends starting pap screening ....

SEATTLE, Feb. 23, 2012 – Based on a study of nearly 2,000 breast-cancer patients, researchers at the Swedish Cancer Institute say that, in women between the ages of 40 and 49, breast cancers detected by mammography have a better prognosis. The study appears in the March issue of Radiology.

“In our study, women aged 40 to 49 whose breast cancer was detected by mammography were easier to treat and had less recurring disease and mortality, because their cancer was found at an earlier stage,” Henry Kaplan, M.D., medical oncologist with Swedish Cancer Institute (SCI).