Pharmacy Times

WOMEN'S HEALTH WATCH


Hispanic Women Have the Best Outcomes of Pregnancy

A recent survey found that Hispanic American women have lower rates of preterm delivery and fewer low-birth-weight babies than either non-Hispanic white or black women. The study was the first conducted in a primarily non-Mexican Hispanic population, but it showed the same results as in similar testing in Mexican Hispanics. The findings appeared in the January 2006 issue of the Journal of Reproductive Medicine.

Hispanics are the fastest-growing minority in the United States, and they represent the majority of the population of Florida's Miami-Dade County, where the study took place. Even though Hispanics often have lower socioeconomic status than other groups, they tend to have better health outcomes, especially in pregnancy.

The study involved data from almost 81,000 deliveries that took place at Jackson Memorial Hospital in Miami during an 11-year period. Over one third of these deliveries were to Hispanic mothers, mainly of Caribbean, Central American, or South American origin. The rate of low birth weights in this population was only 9%, compared with 11% in non-Hispanic whites and 18% in non-Hispanic blacks. The Hispanic women also were less likely to deliver prematurely.


Libido Problems May Last Longer with Pill

According to the results of a recent study from the Lahey Clinic in Boston, women who take birth control pills might be at an increased risk of long-term loss of sexual desire. The findings showed that lowered testosterone levels caused by use of "the pill" can persist for up to 12 months after a woman stops taking a contraceptive. This effect may cause her to experience a decrease in sexual desire. The results were published in the January 2006 issue of the Journal of Sexual Medicine.

The researchers studied 124 premenopausal women, who were divided into 3 subgroups: those who had been on the pill for >6 months and kept taking it, those who had been on the pill for >6 months and then stopped, and those who had never taken the pill. The researchers did blood tests to measure the production of sex hormone-binding globulin (SHBG), a protein made by the liver that binds to testosterone. Levels of SHBG were higher in women on the pill.

Women who had stopped taking the pill were observed for 12 months or more after stopping, and at an average of 11 months they were found to have SHBG levels twice those of women who had never used the pill.

Levels in women who continued taking the pill were 4 times greater than in those who had never taken it. Researchers stated that, "if that?protein is still?elevated, you might have a decrease in libido that persists."


Some Women Still Shy About Feminine Health

According to a national survey conducted by Harris Interactive for the Vagisil Women's Health Center (VWHC), nearly two thirds of all US women over 18 years of age are regularly visiting a gynecologist, as recommended by health professionals. The survey also revealed, however, that there is still some hesitation on the part of the women about discussing feminine health and hygiene. Of the respondents, 23% admitted that they had not been completely honest about their personal feminine health habits with their doctors.

Younger women (29% of those aged 18-34) and single women (34% single vs 20% married, respectively) are more likely to admit to not being completely honest with their doctors.The top 5 subjects women were dishonest about were whether or not they smoke or have smoked, exercise habits, diet, the number of sexual partners they have/have had, and the number of alcoholic drinks they have per week.

Adelaide Nardone,MD, FACOG, clinical instructor of obstetrics and gynecology at the Brown University School of Medicine and medical advisor to the VWHC, stated that women should try to locate a doctor to whom they can relate.


Problems Found with Genetic Test for Breast Cancer

The results of a new study reveal that a widely used genetic test for breast cancer risk can miss mutations that help cause the disease. This finding is likely to increase the pressure to develop more thorough testing methods.

According to the study's authors at the University of Washington, the test, which looks for gene mutations called BRCA1 and BRCA2, did not find them in about 12% of breast cancer patients from families with multiple cases of either breast or ovarian cancer. The results appeared in the March issue of the Journal of the American Medical Association.

"Everyone who has a strong family history and is negative should be considering how negative that result really was," said Judy E. Garber, MD, MPH, director of the cancer risk and prevention program at the Dana-Farber Cancer Institute in Boston, Mass. Experts say that women from families with multiple cases of breast and ovarian cancer should take precautions just as though they had a mutation, even if none was found on the test.


Osteoporosis Drug Can Lower Breast Cancer Risk

Researchers at the National Cancer Institute reported that a medicine presently in widespread usage to prevent bone thinning in postmenopausal women can also reduce their risk of developing breast cancer. The institute sponsored a study that found that raloxifene works as well as tamoxifen, which is already approved to treat breast cancer and prevent it in high-risk women. In addition, the study found that raloxifene, which is currently being taken by ~500,000 American women for osteoporosis, also may have fewer side effects.

The study included almost 20,000 postmenopausal women who were at high risk for breast cancer based on personal and family histories. The risk of these women developing the cancer in the next 5 years was 3% to 4%, about 2 times the risk of average women. The participants were randomly assigned to take either raloxifene or tamoxifen for 5 years, starting in 1999. The study found that the rates of women developing invasive breast cancer were equal in both groups?167 women out of 4712 in the raloxifene group versus 163 out of 4732 in the tamoxifen group. The rates were about half of what would be expected for similar, but untreated, patients.


Teen Girls Not Getting Enough Calcium

A recent study by the University of Maryland's Center for Food, Nutrition, and Agriculture Policy found that teenage girls and young women in America, especially African Americans, are not getting enough calcium at a time in their development when it is critical to building healthy bones. The results of the study were published in the April issue of the Journal of the American College of Nutrition.

The researchers studied national data from 1994 to 2002 to track changes in calcium intake. They found that, although calcium intake increased in most ages and genders, calcium intake among adolescent girls and younger women still remained well below recommended levels. The Recommended Daily Allowance for girls aged 9 to 18 years is 1300 mg/day, yet the study showed that the average girl in this age group consumes only about 814 mg/day, with lower rates among black teen girls. Study coauthor Maureen Storey, director of the center, stated that "we need to develop strategies for getting more calcium into the diet, especially of the very vulnerable population of young women."


Change in Diet May Improve PCOS Symptoms

Women who suffer from polycystic ovary syndrome (PCOS) may be able to alleviate their symptoms with a low-carbohydrate diet. PCOS is caused by multiple cysts that develop on a woman's ovaries, and symptoms can include excessive hair growth, obesity, menstrual abnormalities, and infertility. The syndrome is also suspected to increase the risk of developing diabetes. Researchers found that a moderate reduction in carbohydrate intake can decrease insulin levels, which in turn can lead to lessening of these symptoms. They explained that higher insulin levels are believed to contribute to the hormonal abnormalities seen in patients with PCOS.

The study involved 11 women with PCOS between ages 19 and 42 years, and ranging in weight from normal to obese. These women were placed on 3 different diet plans for 16-day periods, separated by two 3-week "washout" periods: a standard diet (56% carbs); an enriched monounsaturated fatty acid (MUFA) diet (55% carbs), and a low-carbohydrate diet (43% carbs). Compared with the standard diet, the low-carb diet lowered insulin levels; and the usual jump in insulin in response to glucose was lower after the low-carb diet, compared with the enriched MUFA diet. The findings were published in the March edition of Fertility and Sterility.


Estrogen Not Linked to Posthysterectomy Cancer

Women who take estrogen after having a hysterectomy are not increasing their risk of developing breast cancer, according to research from a government study. The Women's Health Initiative, a federally funded 15-year research program to address the most common health issues for women, found that, although the hormone increases the risk of other conditions such as strokes and blood clots, there was no incidence of raised rates of breast cancer in estrogen patients. The results were published in the April 12, 2006, edition of the Journal of the American Medical Association.

Almost 11,000 women who had hysterectomies were enrolled in the estrogen substudy and were randomly assigned either daily estrogen or placebo. The study showed a minor reduction in instances of breast cancer among those taking estrogen?not a large enough difference to indicate a direct benefit, but enough to conclude that there was no increased danger of breast cancer risk while taking estrogen.

Doctors emphasize that women should still consult with their physician to determine if estrogen therapy is right for them, and the therapy should be taken at the lowest possible doses for the shortest possible time.