FEBRUARY 01, 2007

Preconception Health Just as Important as Prenatal Health

For generations, women have been told to make sure that they see a doctor as soon as they find out they are pregnant to ensure the optimal health of their babies. Now potential mothers are being encouraged to take better care of themselves even before they conceive. Public health officials say that, by the time a woman makes it to her first prenatal visit, she is usually 10 to 12 weeks pregnant—and "if a birth defect is going to happen, it's already happened" by then, according to Peter S. Bernstein, MD, MPH, FACOG, a maternal fetal medicine specialist at Montefiore Medical Center in New York, who helped write new government guidelines on what is being called "preconception care."

The new guidelines, issued by the Centers for Disease Control and Prevention in the spring of 2006, include 10 specific health care recommendations and advise prepregnancy checkups that include screening for diabetes, HIV, and obesity; managing chronic medical conditions; reviewing medications that may harm a developing baby; and making sure that the mother's vaccinations are up to date. Daily doses of folic acid should be taken 3 months prior to conception.

Stopping Menstruation Aids Cancer Survival

Women who undergo chemotherapy to treat breast cancer sometimes experience amenorrhea, or cessation of their monthly periods. A new study from Austria shows that this has added benefits for these women, as it has been shown to help them live longer and have fewer relapses. The researchers also found that women who still get their periods despite chemotherapy could benefit from treatment that lowers their natural levels of estrogen, which has been shown to fuel cancer cells. The study results were presented at the 29th Annual San Antonio Breast Cancer Symposium in Texas in December 2006.

The study included 500 premenopausal women who were taking chemotherapy drugs for breast cancer. About 50% of these women experienced amenorrhea due to taking the medicines, and all of them had hormone-receptor-positive tumors (which feed off of hormones), the most common type of breast cancer. After 10 years since the start of chemotherapy, women whose periods had stopped were 40% less likely to suffer a recurrence than those whose periods did not stop. These women were also 10% more likely to survive the cancer, and almost all of them were under age 40 when they started chemotherapy.

Iron Supplements May Reduce Infertility Risk

A new study suggests that taking iron supplements might reduce the risk of infertility. Researchers from Harvard School of Public Health and Medicine in Boston, Mass, examined data on women enrolled in the Nurses' Health Study II. The women were between ages 24 and 42. Over 8 years of follow-up from the study, researchers noted over 3500 cases of infertility among over 18,000 women who were attempting to become pregnant. Of those women, 2165 were medically evaluated to try to determine the cause of their infertility, and 438 of those were found to suffer from an inability to produce viable eggs.

After adjusting for such factors as age, smoking status, physical activity, and eating habits, it was shown that women in the study who used iron supplements regularly had an average 40% less risk of ovulatory infertility than those who did not take iron. It was also shown that the higher the dose of iron, the lower the risk of infertility; women who took the highest doses of over 41 mg/day reduced their risk by 62%. The findings were published in the November 2006 edition of Obstetrics & Gynecology.

Black Cohosh Doubtful for Menopause Treatment

Many women suffering from the symptoms of menopause turn to dietary supplements containing the herb black cohosh for relief. A recent study has found, however, that the herb has no more effect on menopause symptoms than placebo. Sales of the supplement rose significantly after a study sponsored by the National Institutes of Health (NIH) in 2002 reported that hormone therapy raised users' risk of heart attacks, breast cancer, blood clots, and stroke. American women turned to black cohosh in droves, spending 26% more on the herb in the year following the study's release.

Researchers from NIH studied black cohosh, compared with placebo, in 351 women, aged 45 to 55, who were divided into 5 treatment groups for 1 year: hormone therapy; black cohosh 160 mg/day; a supplement consisting of 200 mg of black cohosh and other botanicals; the multibotanical supplement plus counseling to consume more soy foods; and placebo. The double-blind study required each woman to have already experienced 2 hot flashes a day; the average was 6. After 3, 6, and 12 months of treatment, the researchers found no significant difference in the occurrence of hot flashes between the black cohosh groups and the placebo group—only the hormone therapy was more effective.