Women and Heart Disease

Believe it or not, the number one killer of women is heart disease, formerly thought to be a “man’s disease”.

What is heart disease? 

Your heart is a muscle that gets energy from blood carrying oxygen and nutrients. Having a constant supply of blood keeps your heart working properly. Most people think of heart disease as one condition. But in fact, heart disease is a group of conditions affecting the structure and functions of the heart and has many root causes. Coronary artery disease, for example, develops when a combination of fatty materials, calcium and scar tissue (called plaque) builds up in the arteries that supply blood to your heart (coronary arteries). The plaque buildup narrows the arteries and prevents the heart from getting enough blood (Heart & Stroke Foundation).

Why does heart disease affect women?  Women are more likely than men to have coronary MVD. Many researchers think that a drop in estrogen levels during menopause combined with other heart disease risk factors causes coronary MVD.  The disease affects women differently than it does men.  This can cause many women to be misdiagnosed.  Here are the differences:

• For women, heart disease symptoms may be subtle – but when a heart attack
  strikes, women are more likely to die than men. Women are also at twice the risk
  of death following open heart surgery, compared to men
• Heart damage is more likely to occur in women when the small blood vessels become obstructed from plaque.
• Women are also more likely to maintain heart function after a heart attack, unlike men whose heart muscle becomes weaker; 38 percent of women die from heart attack, making heart attack more lethal for women than men.
• Women are also more likely to have a second heart attack within six years of their first one, unlike men.
• Women are also less likely than men to have obstructive coronary artery disease.

Women are also more likely than men to have a condition called broken heart syndrome. In this recently recognized heart problem, extreme emotional stress can lead to severe (but often short-term) heart muscle failure.  Broken heart syndrome is also called stress-induced cardiomyopathy (KAR-de-o-mi-OP-ah-thee) or takotsubo cardiomyopathy.

Doctors may misdiagnose broken heart syndrome as a heart attack because it has similar symptoms and test results. However, there’s no evidence of blocked heart arteries in broken heart syndrome, and most people have a full and quick recovery.  Researchers are just starting to explore what causes this disorder and how to diagnose and treat it. Often, patients who have broken heart syndrome have previously been healthy.

Women’s College Hospital in Canada where I go offered the following differences between the sexes and the effects of heart disease:

Women Tend to Develop Heart Disease at a Later Age

Women tend to develop heart disease later in life because they are often (though not always) protected by high levels of estrogen until after menopause. Men’s risk of developing heart disease increases in their 40s. A woman’s risk of heart disease becomes similar to a man’s risk about 10 years after menopause.

Women Experience More Silent Heart Attacks

Women experience more silent heart attacks than men. That is, a woman may not know she has had a heart attack. Women are also more likely to have a single artery narrow whereas men tend to have multiple arteries narrow.

Women Are More Likely to Be Suffering from Other Health Problems

Women are more likely to be suffering from other health problems, such as diabetes and high blood pressure, when they have heart problems.

Women Do Not Always Get the Health Care They Need

Heart disease is under-detected in women. Once women do seek treatment, doctors do not always recognize their symptoms as the symptoms of heart disease. Women are also less likely to be referred to a heart specialist, to be hospitalized, to be prescribed medication or other treatment, or to be referred for exercise testing. As a result, women do not always get the health care they need.

I find it unsettling that women are not always getting the health care they need when they seek treatment for heart disease.  They should receive the same considered as men.  They should be referred to a heart specialist or hospitalized or given whatever care they should be entitled to.  It’s time for women to stop being under served and under treated.  In the mean time, educating women about their risk of the disease and how to take control of their health so that they can reduce that risk.  Whenever I go for my annual checkup, my doctor always orders an ECG for me.  Although I just read that ECG tests are not recommended by a government backed panel.  Read article.  Heart for Life has information on screening and heart tests on their website.  Check them out here.

I read that young women can have heart disease too.  Even though heart disease among women becomes more common after menopause, it affects younger women.  Every year in the U.S., heart disease kills about 16,000 young women and accounts for 40,000 hospitalizations in young women, according to the American Heart Association.  Young women may experience symptoms of a heart attack and fail to recognize them as such for the following reasons:

• They thought they were too young to be having a heart attack.
• They had atypical symptoms that lasted for more than a day.
• They chalked up their symptoms to other conditions, not to a heart attack.

African American women are more at risk for heart disease than Caucasian women. And, if an African  American woman has a heart attack, she is 69 percent more likely to die of that  heart attack than a Caucasian woman.

Don’t be discouraged.  The Heart & Stroke Foundation assures us that heart disease is preventable and manageable.  They say that our defense is controlling the risk factors that could lead to coronary artery disease, such as high blood pressure, high cholesterol, diabetes, smoking, stress, excessive alcohol consumption, physical inactivity and being overweight.  Here are healthy heart steps we need to follow:

• Be smoke-free.
• Be physically active.
• Know and control your blood pressure.
• Eat a healthy diet that is lower in fat, especially saturated and trans fat.
• Achieve and maintain a healthy weight.
• Manage your diabetes.
• Limit alcohol use.
• Reduce stress.
• Visit your doctor regularly and follow your doctor’s advice.

Let us take action today.  Let us keep our hearts healthy.

Women tend to think that breast cancer is their biggest health threat. And while it’s important, heart disease remains the No. 1 killer of women, even young women. But that message just hasn’t been fully recognized – cardiologist Nicea Goldberg, MD, director of the Women’s Heart Program at NYU Medical Center and author of the new book Complete Woman’s Guide to Women’s Health.

Sources:  http://www.womensheart.org/content/heartdisease/heart_disease_facts.asp; http://www.webmd.com/heart-disease/features/women-and-heart-disease-key-facts-you-need-to-know; http://womenshealth.gov/publications/our-publications/fact-sheet/heart-disease.cfm; http://www.oprah.com/health/Facts-About-Heart-Disease-for-Women; http://www.reuters.com/article/2012/07/30/us-ecg-heart-idUSBRE86T1EE20120730; http://www.nhlbi.nih.gov/health/health-topics/topics/hdw/; http://www.emaxhealth.com/1020/heart-disease-affects-women-differently-men; http://www.womenshealthmatters.ca/health-resources/heart-health; http://www.modernmom.com/article/women-and-heart-disease-getting-the-right-health-care;  http://www.webmd.com/heart-disease/news/20080502/younger-women-miss-heart-attack-signs; http://www.heartandstroke.on.ca/site/c.pvI3IeNWJwE/b.4007287/k.4ACF/Heart_Disease__What_is_heart_disease.htm

Women And Infertility

I was watching General Hospital and one of the characters received the news that she could not have children.  Any child she carried would not be carried to full term.  She would lose the baby.  What heartbreaking news.  It hurts to see women who want to be mothers and who would be great mothers unable to have children while those who are unfit have children.  It doesn’t seem fair.  Lulu, the character wondered why this happened to her since there was no family history of infertility.  Before that she blamed herself for her condition because she had had an abortion when she was a teenager.

I have often wondered why are some women unable to have children or carry them to full term?  There was a time when I was afraid that I would not be able to have children.  In biblical times barren women were looked down upon by other women.  Sarah was despised by her servant Hagar because she was able to conceive while her mistress couldn’t (Genesis 16:4).  Hannah was tormented by Peninnah, her husband’s other wife and rival because the LORD had closed her womb.  She made Hannah’s life a living hell until God blessed Hannah with children.  Rachel rejoiced when she conceived her first child, saying, “God has taken away my reproach” (Genesis 30:23).

In developing countries women face ostracisim and see their infertility as a failing or a curse.  Newsweek ran a story in 2008 about women around the world who are coping with infertility.  One woman was uable to conceive for the first 13 years of her marriage.  She said that people would ask a woman her name—and then, “How many children do you have?” When the woman answered “none”, they don’t know what they can talk to you about.”

It must be so difficult for a woman to be surrounded by family members and friends who have children of their own or to see mothers where ever you go with their children and know that she would never have that experience.  It’s ironic. There are women who can have children but choose not to and there are women who would like to be mothers but are unable to have children.

What causes infertility in women?  Women’s Health Government has a fact sheet which answers these and other questions about infertility.

What is infertility?

Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile.

Pregnancy is the result of a process that has many steps. To get pregnant:

• A woman’s body must release an egg from one of her ovaries (ovulation).
• The egg must go through a fallopian tube toward the uterus (womb).
• A man’s sperm must join with (fertilize) the egg along the way.
• The fertilized egg must attach to the inside of the uterus (implantation).

Infertility can happen if there are problems with any of these steps.

Infertility among women is common.  According to  the Centers for Disease Control and Prevention (CDC) about 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant.

What causes infertility in women?

Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause.

Less common causes of fertility problems in women include:

• Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
• Physical problems with the uterus
• Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.

What increases a woman’s risk of infertility?

Many things can change a woman’s ability to have a baby. These include:

• Age
• Smoking
• Excess alcohol use
• Stress
• Poor diet
• Athletic training
• Being overweight or underweight
• Sexually transmitted infections (STIs)
• Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency

Check out the Women’s Health Government fact sheet to find out how age can affect a woman’s ability to have a child; how long a woman should try to get pregnant before consulting a doctor; how a doctor determines if a woman and her partner have fertility problems and treatments.  They also offer more information (links) on infertility that may help you or someone you know who may be having difficulty getting pregnant.

Glen Meade Center for Women’s Health outlines the ways in which women can be tested for infertility:

• Blood tests to check hormone levels, including progesterone and follicle stimulating hormone (FSH)
• Checking morning body temperature to determine if ovaries are releasing eggs
• Hysterosalpingography (a radiologic assessment of the uterus and fallopian tubes)
• Pelvic ultrasound
• Laparoscopy (inspection of pelvic region)
• Luteinizing hormone uterine test (ovulation prediction)
• Thyroid function tests

There is hope for women experiencing infertility.  Glen Meade offers the following treatment options depending on the cause of the infertility:

• Education and counseling
• Fertility treatments, such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
• Medications that treat infections and clotting disorders
• Medications that help women grow and release eggs from the ovaries

Notes to Women wants to reach out to women facing infertily by encouraging them to read articles from women who are coping with it such as this one.  We hope that the tips for living with infertility will be helpful to you and give you some comfort.

Sources:   http://womenshealth.gov/publications/our-publications/fact-sheet/infertility.cfm; http://www.glenmeadehealth.com/ms_infertility.html; http://www.thedailybeast.com/newsweek/2008/09/14/what-it-means-to-be-a-woman.html

Women and Arthritis

My mother used to have severe pain in her knees due to arthritis before she got replacements in them.  I remember how swollen they looked.  She told me that the arthritis might have been the result of scrubbing the floor on her knees.  Since then they hurt and her mother put on them but they burned her.  There were times when my mother asked me to massage her knees because they hurt.  And what made it worse was the lack of bone density which made the bones in her knees rub together.   My mother-in-law has arthritis in her knees too and one of my aunts has rheumetoid arthritis.

Just recently on TV I saw a promotion for the 2012 Walk to Fight Arthritis which takes place across Canada on June 10.  This got me thinking about writing a post on Arthritis.  What is Arthritis and what causes it?  What are the symptoms?  Can we prevent it?  I searched the Internet to find the answers to these questions and learned so much in the process.

There are more than 100 types of arthritis.  However, there are two common types–osteoarthritis, which is the “wear and tear” arthritis, and rheumatoid arthritis

Here are 10 facts about arthritis:

1. Arthritis is far from a new disease.  In fact, many researchers believe it has been a part of civilization since the beginning of time, even affecting dinosaurs millions of years ago.  Researchers also believe that skeletal remains from humans living around 4500 B.C. show signs of the disease.
2. Did you know that the word arthritis literally means joint inflammation?  That’s right, the word arthritis comes from the Greek words for joint (arthro) and inflammation (-itis).
3. There are over 100 forms of arthritis, including little talked about diseases like Kawasaki disease, which involves inflammation of the blood vessels, and Sweet’s syndrome, which is a skin condition marked by fever and painful skin lesions.
4. Were you aware that arthritis is the most common cause of disability in the United States?  According to the CDC, arthritis and rheumatic conditions cost the U.S. economy $128 billion annually and result in 44 million outpatient visits and 9,367 deaths each year.
5. Movement is one of the best treatment options for arthritis and can help most people prevent the onset of the disease in the first place. The U.S. Department of Health & Human Services (HHS) reports that strong evidence indicates both endurance and resistance types of exercise provide considerable disease-specific benefits for persons with osteoarthritis (OA) and other rheumatic conditions.
6. Osteoarthritis is the most common form of arthritis and is a chronic disease that affects some 27 million Americans. OA is characterized by the breakdown of cartilage, which can cause stiffness and pain.
7. There are two types of OA – primary and secondary. Primary osteoarthritis is generally associated with aging and the “wear and tear” of life. The older you are, the more likely you are to have some degree of primary osteoarthritis. Secondary osteoarthritis, in contrast, tends to develop relatively early in life, typically 10 or more years after a specific cause, such as an injury or obesity.
8. Did you know that children get arthritis too?  Nearly 300,000 children in the United States are living with juvenile arthritis.  Juvenile arthritis (JA) refers to any form of arthritis or an arthritis-related condition that develops in children or teenagers who are less than 18 years of age.
9. Juvenile arthritis is one of the most common chronic childhood conditions, occurring nearly as often as insulin-dependent juvenile diabetes.  The most common form of arthritis in children is juvenile rheumatoid arthritis (JRA), which has two peaks of onset: between 1 and 3 years of age and between 8 and 12 years of age.
10. Arthritis is more common among women (24.9%) than men (18.1%), and girls are twice as likely to develop juvenile rheumatoid arthritis as boys.

Some of the risk factors which can cause arthritis include:

• Genetics
  Exactly how much heredity or genetics contributes to the cause of arthritis is not well understood. However, there are likely genetic variations that can contribute to the cause of arthritis.
• Age
  Cartilage becomes more brittle with age and has less of a capacity to repair itself. As people grow older they are more likely to develop arthritis.
• Weight
  Because joint damage is partly dependent on the load the joint has to support, excess body weight can lead to arthritis. This is especially true of the hips and knees that can be worn quickly in heavier patients.
•  Previous Injury
  Joint damage can cause irregularities in the normal smooth joint surface. Previous major injuries can be part of the cause of arthritis. An example of an injury leading to arthritis is a tibial plateau fracture, where the broken area of bone enters the cartilage of the knee joint.
•  Occupational Hazards
  Workers in some specific occupations seem to have a higher risk of developing arthritis than other jobs. These are primarily high demand jobs such as assembly line workers and heavy construction.
•  Some High-Level Sports
  It is difficult to determine how much sports participation contributes to development of arthritis. Certainly, sports participation can lead to joint injury and subsequent arthritis. However, the benefits of activity likely outweigh any risk of arthritis.
• Illness or Infection
  People who experience a joint infection (septic joint), multiple episodes of gout, or other medical conditions, can develop arthritis of the joint.

According to a Mayo Clinic Study, rheumatoid arthritis is on the rise among women.  In rheumatoid arthritis, women are up to three times more likely to develop the condition than men. Many women with rheumatoid arthritis go into remission during pregnancy. To date, no one has been able to determine the exact cause of this beneficial effect, but one theory is that changes in hormone levels may effect the level of proteins in the blood that contribute to inflammation.

What are the symptoms?  

Symptoms of arthritis include pain and limited function of joints. Inflammation of the joints from arthritis is characterized by joint stiffness, swelling, redness, and warmth. Tenderness of the inflamed joint can be present.

Many of the forms of arthritis, because they are rheumatic diseases, can cause symptoms affecting various organs of the body that do not directly involve the joints. Therefore, symptoms in some patients with certain forms of arthritis can also include fever, gland swelling (swollen lymph nodes),weight loss, fatigue, feeling unwell, and even symptoms from abnormalities of organs such as the lungs, heart, or kidneys.

Are there ways to prevent arthritis?  According to the Arthritis Foundation, it can be.  They offer these common tips for prevention:

• Eat a healthy, well-balanced diet to help maintain your recommended weight. Women who are overweight have a higher risk of developing osteoarthritis in the knees. Learn more about nutrition.

• Talk to your doctor about taking vitamin and mineral supplements. Having insufficient levels of vitamin D decreases the amount of calcium your body can absorb. That coupled with lower calcium levels as you age can help contribute to osteoporosis. Check out the Arthritis Today Vitamin & Mineral Guide.

• Exercise regularly to strengthen muscles around joints and help increase bone density. Exercise may reduce wear and tear on your joints, which can help prevent injury and reduce the risk of osteoarthritis. Increased bone density also can help stave off osteoporosis. Check out some exercise routines or get moving with the Arthritis Foundation.

• Avoid smoking and limit your alcohol consumption to help avoid osteoporosis. Both habits weaken the structure of bone, which puts you at higher risk for fractures.

• Discuss hormone replacement therapy (HRT) with your primary care provider if you are postmenopausal. Many women lose bone mass during the pre- and postmenopausal years when their ovaries stop producing estrogen. One of estrogen’s functions is to help keep calcium in the bones and maintain bone mass. Lowered estrogen level is a major cause of osteoporosis in women after menopause.

If you suspect that you have arthritis, see your doctor.  To diagnose arthritis, your doctor will take a thorough history and conduct a physical examination to determine which joints are affected.  If you are someone currently suffering with arthritis or was recently diagnosed with it, here is a website that may offer you some support.  Another great website to visit is http://www.arthritistoday.org/.  You can join the community and meet people who know exactly what you are going through.

Sources:  http://www.arthritis.org/women.php; http://www.webmd.com/rheumatoid-arthritis/guide/most-common-arthritis-typeshttp://arthritis.about.com/od/arthritissignssymptoms/a/women_arthritis.htm; http://orthopedics.about.com/od/arthritis/f/arthritiscauses.htm; http://www.medicinenet.com/arthritis/article.htm#Whatisarthritis; http://bodyandhealth.canada.com/channel_condition_info_details.asp?channel_id=42&relation_id=107751&disease_id=239&page_no=2

Smoking and Women

A long time ago I took one drag on a cigarette and vowed never to touch another one again.  It made me cough and I felt terrible.  My sister used to smoke but then she stopped.  I have a cousin who used to smoke and her lips looked black.  I used to work with a woman who smoked while she was pregnant.  I have to admit that although I don’t like seeing anyone smoke because it’s not good for your health, I dislike seeing women smoke even more. 

In the movies they make it look glamourous.  Bette Davis looked sophisticated with a cigarette in her hand in Now Voyager.  It seemed so romantic when Paul Henreid lit both cigarettes and give her one. 

Smoking is anything but romantic or glamourous.  It is dangerous for your health.  Sadly, despite the many warnings that cigarettes can cause cancer and increase our risk of heart disease, approximately 23 million women in the US (23 percent of the female population) still smoke cigarettes. Smoking is the most preventable cause of death in this country, yet more than 140,000 women die each year from smoking related causes. The highest rate of smoking (27 percent) occurs among women between twenty-five and forty-four (http://womenshealth.about.com/cs/azhealthtopics/a/smokingeffects.htm).

The most common side effects of smoking are:

Pulmonary and Respiratory Disorders:  Smoking increases your risk of developing a condition called chronic obstructive pulmonary disease. The lung damage that occurs from pulmonary disease is not often reversible. However, if you do quit smoking your lung function will not decline further, and you may notice an improvement in coughing and breathing.

Cardiovascular disease:  Cigarette smoking is a leading cause of cardiovascular disease in the United States. Women who smoke more than double their risk of developing cardiovascular disease. Immediately stopping smoking can result in instant improvement in your cardiovascular function and a reduced risk of heat disease. After smoking cessation has continued for at least a year, your risk of developing cardiovascular disease drops by 50 percent. Your risk continues to decline the more years you remain smoke free. Some studies suggest the heart attack risk for smoker’s drops to that of nonsmokers after two years of cessation.

Cancer:  Cigarette smoking contributes to developing several different kinds of cancer, including cervical cancer, lung cancer, cancer of the esophagus, mouth, bladder and pancreas. Smoking cessation can improve your survival rate and reduce your risk of developing severe cancers resulting from smoking.

Osteoporosis:  Smoking contributes to bone loss, thus increases a woman’s risk for developing osteoporosis. 10 years after smoking cessation a woman’s excess risk for osteoporosis declines significantly.

Breast Cancer:  Women who smoke are more at risk for breast cancer. In fact, the risk of developing fatal forms of breast cancer is 75 percent higher for women who smoke than those that do not. The number of cigarettes a woman smokes per day can affect their breast cancer survival rate.

Vulvar Cancer: Women who smoke are also 48 percent more likely to develop a rare form of vulvar cancer.

Smoking may also contribute to many other diseases and problems. It is especially dangerous to pregnant women. Babies exposed to smoking mothers are often born with birth defects and low birth weights. Mothers who smoke are also more at risk for miscarriage, premature rupture of the membranes and placenta previa. Babies born to mothers that smoke often experience withdrawal symptoms during the first week of life. Over time smoking also contribute to skin wrinkling and may even reduce your sexual ability. Quitting smoking improves all of these conditions immediately (http://www.womenshealthcaretopics.com/smoking_and_women.htm).

Women are more at risk for certain problems related to smoking than men are. Women who use oral contraceptives or other hormonal forms of birth control are especially at risk for developing serious side effects. Women using hormones who smoke increase their risk of developing life threatening blood clots and strokes.

Women who smoke typically have reduced fertility. Studies suggest that women who smoke are 3.4 times more likely to experience problems conceiving than those who do not. This may be because of a decreased ovulatory response. In some women the egg had trouble implanting when the mother smokes.

Smoking also affects women’s normal cyclical changes, including those that occur during menopause and menstruation. Women who start smoking during their teen years are more at risk for developing early menopause than women who do not smoke. Smokers may also experience more menstrual problems including abnormal bleeding or amenorrhea than women who don’t smoke. This may be because smoking often lowers levels of estrogens in the body (http://www.womenshealthcaretopics.com/smoking_and_women.htm).

Now that we know the risks of smoking, let’s look at some tips that will help women to quit.  I came across an article on How to Quit Cold Turkey written by a woman who used to smoke.  Note these tips are only for women who wish to quit smoking cold turkey.   There are three things you will need:   

• A willingness to Quit
• Some gum
• A team of Support

Read more: How to quit Smoking Cold Turkey! | eHow.com http://www.ehow.com/how_2353369_quit-smoking-cold-turkey.html#ixzz1F84jTm6G

Other steps to quit smoking are:

Step 1

Think about the positive health changes that will take place after you stop smoking.

Step 2

Make improvements in your appearance part of your plan. Aim for a sweeter smelling and better looking you.

Step 3

Get rid of all your cigarettes and put a healthy snack in your mouth instead of a cigarette when you get the urge to smoke. Also replace smoking with an activity you enjoy engaging in or can benefit from to help you quit.

Step 4

Talk to your doctor about taking medicine to help you stop smoking. Ask him if you are healthy enough to use the patch, nasal spray, inhaler, gum or lozenges, and find out which of these products he thinks is best for you.  Read more: http://www.livestrong.com/article/178278-how-women-can-quit-smoking/#ixzz1F868POZ5

I have a friend who used to smoke.  She quit because she read in her Bible, “Or do you not know that your body is the temple of the Holy Spirit who is in you, whom you have from God, and you are not your own?” (1 Corinthians 6:19).  She looks much better since she quit. 

If you are a woman who smokes,  quitting may be the hardest thing for you to do but it will be the best thing in the long run.  You will feel better–more energetic and able to climb a flight of stairs without feeling winded.  And you will have a clear mind.  Plan to quit today.  You can do it!